Life's Booming

Matters of life and death Australia’s death care and funeral industry is big business. We meet death doula Dr Annetta Mallon and funeral industry adviser Martin Tobin, two caring and passionate business owners supporting you and your loved ones through the last step on life’s journey. About the episode – brought to you by Australian Seniors. Join James Valentine for the sixth season of Life’s Booming: Dying to Know, our most unflinching yet. We’ll have the conversations that are hardest to have, ask the questions that are easy to ignore, and hear stories that will make you think differently about the one thing we’re all guaranteed to experience: Death. Featuring interviews with famous faces as well as experts in the space, we uncover what they know about what we can expect. There are hard truths, surprising discoveries, tears and even laughs. Nothing about death is off the table. Dr Annetta Mallon is an end-of-life consultant, doula and educator and grief psychotherapist based in Tasmania. With decades of experience in trauma recovery and personal growth, Annetta helps people understand their rights and options at the end of life – especially those without a strong support network. Martin Tobin is a recognised family name in the funeral business. He is founder of Funeral Direction, a consultancy supporting funeral homes and cemeteries across Australia and New Zealand. A former solicitor, Martin brings legal, strategic and business insight, and is focused on helping the industry evolve through innovation, education and long-term planning. If you have any thoughts or questions and want to share your story to Life’s Booming, send us a voice note – lifesbooming@seniors.com.au Watch Life’s Booming on YouTube Listen to Life's Booming on Apple Podcasts Listen to Life's Booming on Spotify For more information visit seniors.com.au/podcast Produced by Medium Rare Content Agency, in conjunction with Ampel at Myrtle & Pine Studios -- Disclaimer: Please be advised that this episode contains discussions about death, which may be triggering or upsetting for some listeners. Listener discretion is advised. If you are struggling with the loss of a loved one, please know that you are not alone and there are resources available. For additional support please contact Lifeline on 131 114 or Beyond Blue on 1300 224 636. TRANSCRIPT: S06EP03_Matters of Life and Death James: Hello, and welcome to Life's Booming. I'm James Valentine, and this season, we're talking about death. In this episode, we're talking about matters of life and death, well, the final matter, how we say goodbye. Death is big business, and Australia's death care and funeral industry is worth more than $2 billion. And with us are two entrepreneurs, two people who work in this area, supporting you and your loved ones through the last step on life’s journey. We're joined by Dr. Annetta Mallon, an end of life consultant, an educator, and also known as a death doula. And Martin Tobin is a recognised family name in the funeral business and is now an expert adviser on the global funeral industry. Annetta, Martin, welcome to Life's Booming. So many places to start. I'm excited. And Martin, I'll start with you. What's it like when the family business is death? Martin: Yeah, well, it's all I've ever known. When I was, you know, when I was born and grew up, I, we actually lived in a funeral parlour. Um, so when I was, for the first two or three years of my life, uh, the funeral parlour was downstairs. We lived upstairs. So when it's all you've known, you don't think anything different of it. And I suppose all of my friends and sort of social groups when I was young and a teenager thought it was pretty quirky and funny, but for me, it was what I knew. My grandfather and his brother started our family business in the thirties. And by the time I came along, it was well, well and truly established. I didn't really work directly in it straight away after leaving school, but it was always in the background. And so I've always been comfortable with it. James: Yeah. But such an interesting thing. Like what's, what's the dinner time conversation. Did you have a good day, darling? Good deaths? Some good deaths? Martin: Well, all of that. You know, I think that's the stereotype, isn't it, that funeral directors are a bit, sort of weird and severe and a bit morbid, but, but it's, it's far from the truth. You know, I think most people who work in funeral service, and the work that Annetta does, are really warm and loving and gregarious people because you have to have those qualities to really survive and thrive in, in what we do in that space. James: You kind of got to love life, Annetta. Annetta: Absolutely. We are fiercely alive until we are dead. And I think that. Whether it's from the professional funeral side of things or more from consumer advocate and personal support side of things, coming in with a joke – why do we screw the coffin lids down so hard to keep the oncologist out. Great icebreaker: show up with cake. Make jokes, because most of us have a lot of laughter and love in our lives and it's important to leaven sorrow and, and grief. Martin: Yeah. Don't let death just drown out the… James: What's the undertaker's joke? Martin: Oh, there's so many. I mean, everyone used to, I used to get called Stiffy Tobin, that sort of stuff. James: Stiffy, Tobin… Martin: …you know, a bit. So a lot of funeral directors get called Stiffy. Annetta: …that's a 1930s cartoon character, isn't it? James: It's like, it's the, the Millers, the Millers and bakers are Dusty. You know, it's that, it's that era, isn't it? Annetta: You're a Tintin character. James: Yeah, exactly. Martin: Yeah. Luckily I wasn't, you know, I don't fit the stereotype of tall and gray. I'm sort of fairly short and not gray. And so when I joined our family business, I was quite young. So I was lucky I sort of didn't fit that stereotype. And back in the early 90s, there was very few women, very few people, young people, very few people from, from diverse backgrounds. So it's changed a lot really for the better in that sense. So there's no stereotypical funeral director now it's, it's a really, really diverse. James: What's a, what's a doula? Annetta: Well, a doula is someone who supports life's transitions. So I've been a birth doula, and it's a very powerful energy when someone comes into the world, but it's really not my jam. I like the other transition, and I'm better at it. I provide an awful lot of information for people who have questions like, what is this going to feel like? Should I be at home or should I be in the hospital? And the point of a lot of my conversations is not to provide answers, but to support people into recognising what's best for them, which I suspect is actually quite a lot of what Martin does, with the way that you work with businesses. James: When do you turn up? Annetta: A piece of string question. I can turn up pre-need, so there's no terminal or life limiting diagnosis. There's a bit of a myth that we turn up magically, like a fairy, in the last 24 hours of life. That's not really great or optimal. James: So, do some people get you, even if, well, I don't have a diagnosis, but I want to start working with a doula? Annetta: If you're a doula like me who does planning and can answer questions and help people prepare their documentation and their wishes, because that's not anything you want to be doing at the last minute and in cases where there's dementia and cognitive decline. It's too late then to get your planning in place. So I also help to support and foster family-wide and network-wide conversations so that everyone understands if someone's interested in assisted dying, let's talk about that. Does anyone have questions, for example. Or have you considered your pets in your planning? Are you including your grandchildren or just your children? Would you prefer to die in a medicalised environment, ideally, or in a home like environment? James: So you can, yeah, so you're there at any point and really every circumstance is entirely different. Annetta: It is, it's unique every single time. James: Same for funerals? Martin: Yeah, I mean, a funeral really should be a reflection of the person's life and interests and values and philosophies, and sometimes, you know, historically, traditionally, in say the last couple of hundred years that, that often revolved around their, their faith. So these days funerals are quite sort of open-ended, quite, quite unstructured, quite celebratory and people are trying to find some ritual in that and some meaning in that and, and that's the, that's the real change that's happening in funeral service. You know, funerals have been going on for thousands of years. They're one of the early rituals of human, human existence. So, and they emanate from the human need to stop when someone from among us leaves us, and reflect on that person's life, to typically grieve that person, if they meant something to us. So that is, you know, invariably people feel sad, not always, but typically. And people have to then say, well, how do we, how do we move forward without this person? And then for a lot of people, that's incredibly difficult. Grief, grief is just our response to loss. You can't control it. You can't make it go away. So if you suppress it in the early days, it comes back to bite you later. So a funeral is a chance to gather, reflect, embrace the reality of the death and embrace the early stages of the grief, the pain that you'll often experience, and to receive support from your community and to let go of that person because they go from being with you to being a memory. James: It's interesting the way you phrased it or the point of view you expressed there was to me it was the person closest to whoever's died, it's for them. And then it's for the community. It's not for us. Funeral's not for the guy that died. The funeral's for us. Martin: Yep, that's right. And we're finding a lot of people now trying to sort of orchestrate their own celebration and say, this is what I want. I want this to happen, that to happen. And that's, that's got a place, but it's really for the living, for the, for those that are left behind. And, you know, the dead, the dead can't tell the living what, how to feel. But they can give guidance and direction, but I think it's really important that the funerals, funerals are done the way that the survivors feel they need, need to do it so that they, that helps them get back into life afterwards. James: Yeah. Yeah. Would you agree? What's a funeral for? Annetta: I think a funeral is an opportunity to remember why your person was so important to you. One of the big changes that I think we're going to see more and more of in Australia now, with assisted dying nationally available, is a fabulous ‘going away party’, as I call them. So people who attend their own funerals, because basically, especially if you're in a hospital, you know when your time is coming. So there's almost like a bookending effect where we have a celebration with the person and they get to say goodbyes and explain to people why they were important and hear all the good stuff. Then there's probably going to be a gathering of some kind afterwards, possibly ham rolls and whisky will play a part, because, as Martin has said, we need to commemorate the fact that this aspect of our lives is now irrevocably changed. I think for a lot of us, the relationship goes on, but it's very different. I still talk to my mother and my grandmother, both of whom are dead. I don't expect them to respond. But there's still kind of… James: …I think that's the sane way to do it. If you expect them to respond, I don't… Annetta: That's a different conversation. James: That's different. Yeah. We're doing another whole episode on that. Martin: Different podcast. Annetta: Different podcast. James: From Beyond the Grave. Welcome. So again, the funeral's not really for the dead person. Annetta: I've never thought a funeral is for the dead person. It is to really bring us out of the immense shock of the raw grief that – and this is a generalisation – is about 72 hours. And that's not a sustainable emotional state. We get to come together. We get to shift from intense grief, the personal experience of loss and that response – because grief is love with no place left to be put – into mourning, which is a more shared communal public sense of loss, which is a really important transitional period in accepting a death, coming to terms with a death, acknowledging a death. And the funeral makes a space that I think is important, not just for the closest people, but for friends, work colleagues, community members. So there is a space that can be welcoming for a variety of community members, which is also really important. Community can be quite intimate and small, it can be broader and more encompassing. Martin: Yeah, look, I think it does need to, I think a good funeral will reflect the person's life. If, if it's, if it's not authentic, if you go to that funeral and you say, Gee, that wasn't about Fred, then clearly the family have got it wrong. So there has to, they have to be the central character, and that has to, you know, has to really reflect who they were, ideally. But if Fred starts micromanaging his service, his celebration, then I think we're missing the point because it really is for, for those left behind to say, what's going to be meaningful for me to help me, you know, take stock of my life now that Fred's, Fred's gone. A good example is, you know, sometimes people these days will often say, look, let's not go to the fuss of a funeral. Let's, let's have a private cremation or burial and we'll have a memorial service, which is fine. And a lot of people choose that. But if Fred's not there, you know, the emotions around how people feel about Fred and the stories about him aren't really aren't heightened enough for people to really feel what they should feel at a funeral. It's hard to sort of get started with your grief, is sort of the perspective I have… James: …But I suppose there's often that, that's often thought of, we're going to do this in a few days, but the memorials in two weeks… Annetta: I think it's individual. And I also think it is broader culture. So for example, in some cultures, from Eastern Europe, there are marker days. So you will have the funeral on a particular day and then you might do something 10 days later. And then the 40th day might be, for example, in the Macedonian community… I still pay attention to ‘death-aversaries’ and I pay attention to it because it's going to affect my mood and the way I go throughout the day because I will be thinking about that person. And ideally, you have had the opportunity to spend time with your person, whether that's in a hospital room. For example, I did that when my mother died. We were allowed to have the room for as long as we wanted with her. Or at home, and you might keep your person at home for a day or two and sing to them, wash them, sit in silence, cry with them, laugh with them. That's, that can be part of the saying goodbye, which the funeral then when it's done properly and appropriately, I think sort of wraps everything up and ties it as neatly together as you can so that you can move into all of the afters of grief. James: Martin, let's talk about the, the business of funerals. It's a big business, isn't it? Martin: Well, it's, it became an industry a hundred plus years ago, something that people started outsourcing to, you know. And initially it was outsourced to cabinet makers who made the coffin. And then they, the cabinet maker said, well I can, not only can I make the coffin, but I can transfer the body from the place of death and… And over a period of time it became an industry. So, it is there, so it is an organised industry in most, most countries around the world. And so the, the organised funeral director will provide a range of services to, you know, support people who've lost, lost someone. In Australia, it's primarily, historically, made up of family owned private businesses that are multi generational family businesses. But about 25 years or so ago, a lot of the well known family businesses were purchased by larger groups. But certainly they're at, in my view, they're at a competitive disadvantage to a generally family owned local community based, family owned business, because they just don't have that essence. James: Yeah. Is it a strange thing? I mean, you've talked very compassionately about grief and about the humanity of what's involved about the moment of death and what people are dealing with. Yet this is something that you'll make profit from, that the company is going to make profit from. Is that a strange, is there a conflict there? Martin: There isn't really. I mean, you know, sometimes I think a lot of the people who are attracted to the industry, yeah, they're talking to a family and they've gone through a loss and there's a lot of grief and pain and there might be, there might be some challenging financial circumstances too that they glean from the conversation. And yeah, that people feel, feel, Oh, gee, how can we add pain to them, or, you know, add, you know, send them an invoice for $10,000, whatever it might be on top of what they're already experiencing. So yeah, it is a little bit uncomfortable, but I think if, if the business has integrity around its pricing and there's, there's genuine options and, and you know, they're not sort of forced into any sort of uncomfortable decisions, then, you know, most people recognise that a funeral, if it, you know, needs to be done in a certain way, there's going to be a cost to that. James: And do you find that, you know, the, the rise of doulas, the presence of doulas, the change… the way in which there seems to be a lot of, a lot of alternatives to those bigger companies or that standard sort of the mahogany casket approach. Is that in a reaction to this sort of somewhat, you know, industrialisation of, of the process? Annetta: Partially, yes, and from my perspective, I think we can, Okay, Boomer, let's give you a big vote of thanks, because at every stage of life, the Boomer generation, it's a cliche for a reason, they've demanded information and choice, and they want things on their terms far more than we'd seen in the silent generation, certainly, and previous generations. So, what are my rights, options, and choices at end of life? What can we do better and differently? It's made space for things like Daisybox Caskets Australia. I'm not affiliated with them, but they offer a lower and a high quality product, but it's less expensive than mahogany, which you mentioned. Not a bad option for families on a budget, not a bad option for cremations. I think, as we are in such an almost overwhelm of information age, people do want to know what's possible and we can readily see that, for example, in the USA, we've got Katrina Spade, who started with the urban death project. James: What’s that? Annetta: The urban death project was an architectural hypothetical exercise. How can we offer a space for respectful memorialisation and body disposition that is not taking up valuable land. And from this, then we have, recompose, which is natural, organic reduction, nor human composting. In Tasmania, we've got the very first water based cremation service. James: What is that? Because I mean, cremation implies fire to me, not water. Annetta: Yes. So it's alkaline hydrolysis. It's a high temperature, high alkaline process of dissolving everything, which at the end you get a product that instead of gray ashes, white, you get a completely sterile liquid, that I personally don't see why we can't use on green spaces, urban green spaces, but it can go down the drain. James: Just water me in the park. Just go water the flowers with me. Annetta: I quite like that. Martin: Splash me into the ocean. James: Splash me into the ocean. Annetta: There we go. And it's, it's about a seventh of the environmental footprint of a flame cremation. Costs about the same, maybe a little bit more, but we also have a team that will transport statewide. We don't do natural burial, we don't have dedicated natural burial, um, spaces in Australia. The UK does it really well. James: Again, what’s natural burial? Annetta: Okay, so instead of going down six feet, like into colder ground, which is anaerobic, there's frequently a lot of concrete involved, you're in essentially like a hotter ground. You've got more microbes and oxygen, you're going to break down faster. And in the UK, the multipurpose spaces where you might be running, sheep, for example, or growing wildflowers or food. In the USA, when you have the composted remains of people, which turns out to be quite a lot, large in volume, they work with a national park, and it actually goes to beautify hiking trails and to recondition public spaces. James: I like all these. Annetta: I like it too. James: They're kind of positive, aren't they? Annetta: There's options for everybody. So it's opening up spaces for non medical community based people like myself. It also means that there's new and exciting ways for funeral directors to then work with people to make the meaningful, personalised, ritual and ceremony and funeral experience. So, thank you, Boomers. We've got a lot of change. James: Yeah.. And is, are the traditional companies, are they embracing this? Are they seeing the need to embrace this? [00:19:15] Martin: The traditional funeral of being in a church and sort of straight to the cemetery with, with everything sort of reasonably structured, that pattern has definitely broken. We're seeing two things in the Australian industry, that is people trending or consumers saying That doesn't do it for me anymore, I'm either going to go for something very simple that's, like, low cost and, you know, where there's not much of a fuss; or people are saying, I want something highly customised, highly celebratory, highly innovative. And the companies that have stayed quite traditional and conservative are actually losing relevance. And so the funeral directors who are seeing those Baby Boomer-led changes, and are responding construct-- who are responding or actually leading the way themselves and coming up with some of those ideas themselves, they're the ones that are becoming or staying relevant and are thriving. You know, there's a funeral company called Tender Funerals who, whose focus and philosophy is that the family are much more involved in the actual funeral, which is, which is a great thing, which is how it should have, how it used to be. You know, the family themselves would… James: So what might take place? What do they, what do they do? Martin: Well, they might wash and dress the body as, as Annetta said, you know, they might, they might carry the coffin in some of the steps that normally the funeral director would, would only do. There's subtle differences and I don't, I don't profess to know a lot about what they do, but, but philosophically their, their message is let's do funerals the way they used to be done, and not outsource everything to the funeral director. So that's a challenge for the organised industry, because people are responding to that, and because people are saying, Yeah, actually, that's how we did use to do it. And I think the work that doulas are doing is getting people comfortable with the conversation, you know, the fact that we all die and that… Annetta: We've checked, everyone dies. Yeah. Martin: Yeah, we worked that out before. Annetta: Spoiler alert. James: Yeah, that's right. Yeah. Martin: So, you know, the organised industry has to realise that with education and Boomer-led sort of innovation, there's a lot more, you know, sort of change and sort of innovation they have to embrace, otherwise they will become irrelevant. Annetta: Whether you're coming from a more business-like perspective or something that's more community led, we all offer skills and services that have value. People train to be funeral directors and celebrants. People train to be morticians, people train to be doulas. And there's an awful lot of ongoing research and continuing education because the legislation is changing very quickly, in terms of documentation, where it's stored, how it's processed. Assisted dying is constantly changing, as we review the laws. And there is a value to that. I'm not a charity. I like to eat meals and sleep under a roof. So, I think one of the unexpected benefits of having more open conversations, generally, is people can recognise, Oh, well, maybe this much for a funeral seems too much, but this is a reasonable sum and I'm happy to pay that sum because we're getting something of value, in the end. That may be more personalised, maybe more ritualised and traditional, but then we have an exchange of something for something. James: But also those pro, the kind of, you know, those newer processes you were describing, even of how we dispose of the body, a more sustainable approach, is going to reflect a lot of people's values, you know, in a way that a traditional cask of being buried at a six feet under. Martin: Funerals don't operate in a vacuum. You know, they're part of the broader society. James: Yeah. Why do you like working in the area of death? Martin: It's a real privilege to, to work with, I mean, you know, the work that Annetta does is amazing. Like to have an open conversation with someone who is facing their own mortality, must, every day, must be an amazing privilege. And the work that I've done historically is after that. So it's, it's not as, it's not as confronting, because it's happened, but it's just really satisfying work to help people, you know, when they are at a low point to do something for them that's valuable, that's meaningful, and to help them with the long-term journey they're about to embark on. A funeral is just one of the first steps in their, their overall journey without that person. And if you can get them off to a good start with a good, you know, this notion of a good funeral, then, you know, then it's incredibly satisfying work. The vast majority of the people that work in funeral service, and I'm sure in the work that you do, are there for the right reasons. They're there because they, they are people-driven people, they love helping. They want to make a difference for people. So, it's a very satisfying industry. But most of what we have, the stereotype of we're all a bit weird and that it's far, it's almost the opposite. James: Annetta, why do you like it? You said you were better than this. You'd been a birth doula but you said ‘I'm better at death’. Annetta: I am better at death. I like puppies, not children, which probably explains a lot. I'm a good story keeper. And someone who is at end of life or is coming to terms with a life-limiting or terminal diagnosis – maybe a slower decline or more rapid decline – there is still an essence of themselves that they would like to have preserved, which I think feeds into this idea of the meaningful, purposeful funeral. The meaningful, purposeful end-of-life, with quality of life until we die, and then trying to offer a quality of life to people as they come to terms with the death of their person, is values driven, I think, in terms of planning. And also, for me, it's about honoring that person and trying to empower them with as much information as appropriate so that they can make informed decisions. I think there's nothing more empowering. When I've done my job really right, I'm not even involved when someone dies. Sometimes I'm in the room and that's okay, but often I will hear from families afterwards. And there's wonderful stories about the time that was spent while their person was dying, caring for their person's body after death, how the family and the friends came together to facilitate all of that, and then how that relationship of community changes, or stays the same, following that. So people then find meaning in their own life, get more excited about planning. The death literacy snowball is a wonderful thing to watch in action. That's my jam. I really love it. James: What do they do? What, what have people told you about death? Annetta: Interestingly enough, for a lot of people, it's not about death itself. It's about being frightened of dying. My pain threshold's in the basement, I don't want to be in pain. That bothers me far more than my moment of death. The people they loved know that they're loved… James: They want that, they want them to know? Annetta: … They want that. They want to know that love has been expressed, which I think is possibly why we're seeing that uptick, too, and people saying, I'd like this playlist at my funeral. I always start with a playlist with planning, you know, control it, be the DJ. Could we talk about this? I'd like these elements. Because it's a way of caretaking in a sense, the people that they're going to leave behind. The messages that people leave are messages of love. I think that's something the film Love Actually got really right, in the beginning. How do I convey that? How can I try and make that my legacy? So we're seeing it arise in, life writing, the narrative of someone's life so that there might be a digital book or voice recordings. We're seeing that with social media platforms where social accounts can be turned into memorial accounts. But I think also we need to prepare ourselves for the fact that sometimes that is all yanked away with no warning, sometimes, by family members who think that that's the right thing to do. And that can leave people devastated. So I think we're all kind of jogging along together, trying to come to terms with all the changes and make them a good fit for individuals. James: Martin, what do you hear? What do hear people say about death? Martin: Most people dread the day, you know, they're dreading the day, they have to get it, get up there in front of all those people, walk through the gathering and everyone's looking at them. And so there's a, there's a lot of dread. People will say, can we just get over and done with? Can we do it tomorrow? You know, when the death's been today, or whatever. So there is that sense that it's going to be an ordeal. So if, after it's happened and you, the feedback is all the conversations you hear are, Oh, that was really special and it went well and, and what a tribute we paid to Dad or Mum, you know, you know, he would have loved it or whatever. You know, that you've lifted all that dread away, and then they move ahead. So they're off to a good start. Otherwise, if we just die and we, we pause for a few minutes and we get back on the bike and start living again, well, you know, that person, all their, what they meant to us and all their stories and history and what they wanted to be said about them just gets shuffled aside and we get on with life again. So I think we, I think most of us deserve a bit better than that. And a funeral is a really good opportunity to just stop the clock for a while. You know, we don't have to wallow in it for weeks. And some cultures do, they actually, they put a real ritual around it. But as a minimum, just have some, some chance where we can say, his life mattered. I think that's, I think that's really good. Annetta: Yeah. James: This has been such a great conversation. Thank you so much, Annetta. Thank you. Annetta: Thank you for having me, James. It's been a pleasure. James: Martin, thank you. Martin: I enjoyed it. James: Terrific. Thanks to our guests, Dr. Annetta Mallon and Martin Tobin. You've been listening to Season 6 of Life's Booming, Dying to Know, brought to you by Australian Seniors. Please, leave a review or tell someone about it. Head to seniors.com.au/podcast for more episodes. May your life be booming. I'm James Valentine.See omnystudio.com/listener for privacy information.

Dying well We’re all going to die, but how we acknowledge death and dying is a very personal experience. Award-winning journalist and author Tracey Spicer and anthropologist Dr Hannah Gould explore etiquette, rites and traditions to find out what makes a ‘good death’. About the episode – brought to you by Australian Seniors. Join James Valentine for the sixth season of Life’s Booming: Dying to Know, our most unflinching yet. We’ll have the conversations that are hardest to have, ask the questions that are easy to ignore, and hear stories that will make you think differently about the one thing we’re all guaranteed to experience: Death. Featuring interviews with famous faces as well as experts in the space, we uncover what they know about what we can expect. There are hard truths, surprising discoveries, tears and even laughs. Nothing about death is off the table. Tracey Spicer AM is a Walkley award-winning journalist, author and broadcaster. And she's an ambassador for Dying With Dignity. A vocal campaigner and advocate for voluntary assisted dying (VAD), Tracey penned a letter to her mother following her painful death in 1999. Dr Hannah Gould is an anthropologist who works in the areas of death, religion and material culture. She recently appeared on SBS documentary: Ray Martin: The Last Goodbye. Hannah’s research spans new traditions and technologies of Buddhist death rites, the lifecycle of religious materials, and modern lifestyle movements. If you have any thoughts or questions and want to share your story to Life’s Booming, send us a voice note – lifesbooming@seniors.com.au Watch Life’s Booming on YouTube Listen to Life's Booming on Apple Podcasts Listen to Life's Booming on Spotify For more information visit seniors.com.au/podcast Produced by Medium Rare Content Agency, in conjunction with Ampel Disclaimer: Please be advised that this episode contains discussions about death, which may be triggering or upsetting for some listeners. Listener discretion is advised. If you are struggling with the loss of a loved one, please know that you are not alone and there are resources available. For additional support please contact Lifeline on 131 114 or Beyond Blue on 1300 224 636. TRANSCRIPT: James: We're all going to die. Happens to all of us. But how we acknowledge death and dying is of course a very personal experience. With our guest and our expert, we're going to explore the etiquette, the rites and traditions seen in Australia and around the world. Someone who knows a lot about the rites and traditions of death is Dr Hannah Gould, an anthropologist who works in the areas of death, religion and material culture. We're also going to be joined by Tracey Spicer, she’s a Walkley award-winning author, journalist and broadcaster. And she's an ambassador for Dying With Dignity. Tracey and Hannah, welcome. Thank you so much. Tracey: Hello. James: Thank you for coming. Hannah Gould. Hello. Thank you for coming. Hannah: Thank you. James: Fantastic. Let's talk death! Tracey: Why not? There'll be lots of fun. James: Do you laugh in the face of death? Hannah: What else can you do? I mean, look, you know. Lots of sadness, lots of joy, every single emotion is reasonable, surely. I mean, it's like the question, the ultimate question of philosophy, of history, of every discipline. Every response is valid. Not always useful, or helpful. James: Yeah. Yeah. Hannah: But valid. Tracey: Well, it's a universal topic of conversation and that's why I've always loved dark humour. Because you do have to laugh, otherwise what do you do? James: I also think it's, it is the ultimate joke that we are all going to die, but we live like we're not going to. We live every day as though it's just not going to happen at all. Tracey: Especially in Western society, I think other cultures have got it right and we're in such deep denial about it. It's detrimental to all of us. James: Yeah. Now this is your area of expertise really, is that do other cultures have it right? Hannah: Everyone does it differently. Right or wrong is kind of a difficult thing to judge. I think certainly there's a big thing called, like, the denial of death thesis, right. And, and people like Ernest Becker, a lot of different philosophers and anthropologists and cultural, you know, analysis have looked at Western culture and gone, Oh my gosh, we are so invested in denying death, right. And whether that's through denying death by religions that say you're going to live forever, like, you know, don't worry, it's not the end. You'll pop off to heaven or whatever it is. Or through, you know, great heroic myths. Yes, you'll die, but the nation will remember you forever. So, you know, you won't really die. You'll be a martyr. Or contemporary, you know. Yes, you'll die, but have you seen how great the shopping is? You know, we can just ignore, we can deny death by being on Instagram and, you know, consuming, right, so, I think Western culture in particular, the way we've organised our society, allows us to not think about death. James: And we've organised death to be somewhere else, usually now. To be in a hospital, to be in palliative care somewhere. And they may be good, but they're not, they're not in the cottage, are they? They're not next to, not in the bedroom. Hannah: Not in the bedroom. So, we know that, say, 70% of Australians wish to die at home. Only about 15% do. And that is a rate that is lower than all these other countries we like to compare ourselves. So Australians are more institutionalised in their death than places like Ireland, like New Zealand, the United States of America, even Canada. We tend, more than other countries, to die in institutions – aged care, hospitals, and hospices. James: Yeah, right, right. The other way in which we deny death is, or the other way in which other cultures have a different attitude to death, will be that it'll either be more accepting – we are all going to die, will be part of their every day – or they may have a notion of reincarnation and coming back, which means that that's a very different attitude to death, really, than a, than a heaven and a hell. Hannah: Yeah, it's not necessarily an end so much. I think that's kind of quite common in, say, you know, Buddhist or Hindu or other kind of dharmic religions, particularly Asian religions. And then, obviously, there's a lot of Asian religion that's part of Australian society, so that's also quite present in Australia. But we can also have a kind of more secular idea about that. You know, a lot of these, a lot of my mum's generation in particular, have kind of a green environmental kind of reincarnation model where she will say, well, I don't particularly believe in heaven, but I do believe I'm going to become compost. Food for worms, you know, I'll come back as a tree or a flower or a tomato plant, you know, and that's, that's a kind of reincarnation of like reintegration into the natural environment, as it were. So there are some kind of myths or stories we can tell ourselves that perhaps help us think about death more positively. James: I've got a, a friend of mine who'd be into her 80s has said, oh, funeral? Just put me up the top paddock, let the crows have a go. Tracey: Yeah. My dad wants to be buried in a cardboard box, and I think that's a wonderful idea. James: We all say that, don't we? That's a really common one as well. I hear that a lot on the radio. People will go, mate, just, I don't care, put me out with the, on the hard rubbish day. Hannah: In the paddock, whatever it is… James: …the paddock, that’s the same sort of thing I said. You know, like, do we really want that, do you think? Hannah: Oh, do we really want that? I do think Aussies are pretty pragmatic about death. I do think we have a certain streak in us that's kind of like, you know what, it's all a bit much fuss, it's all too much. You kind of even get these people who therefore say, don't have a funeral. You know, I really don't want to have a funeral. Please don't even, you know, no fuss. That can be kind of sad sometimes because I think it's some people kind of not acknowledging how many people love them and miss them. James: Yeah. Hannah: Um, but maybe it's also a bit of an Aussie humour, dry humour, that, that black humour again of kind of, you know, trying to laugh in the face of death. Why not? Tracey: I would agree, but then we all get sucked in when we're in the funeral home, and they show you the cardboard box, and then they show you the glossy one that's 10 or 20 thousand dollars, and you think, did I really love that person that much, or should I do it? So it all feeds into what you were talking about before, that consumerism and overcommercialisation. James: Well, I also think sometimes, I would think it's about weddings. Weddings and funerals, well, who's it actually for? Tracey: Yeah, yeah. Well it's a punctuation mark, isn't it? I'm a lifelong atheist, but Tracey: I do enjoy, it sounds terrible, going to those kind of ceremonies, whether it's a funeral or a wedding, because it's important to celebrate or commemorate these changes, these huge changes. James: I love the sharing of stories at a funeral. People start talking. Tracey: Well, you learn so much about someone's life that you may not have known. And also often they're rich for that dark humour. I'll never forget my grandmother's funeral, who I was incredibly close to. And my father's new girlfriend loved my grandmother. She was so distraught she tried to throw herself into the hole in the ground on top when she was throwing the dirt in and I thought, well, that's intense. James: That's good. Tracey: That's, I've never seen that before. That's a first. Hannah: Oh, I've seen that before. Tracey: Have you?! Hannah: I will say that, you know, when you attend enough funerals or attend enough cremations for professional reasons, um, as it were, you kind of see everything, every range of human emotions. Like, we, we kind of think, you know, all funerals are all happy families. A lot of unhappy families, a lot of punch ups at funerals, lots of, uh, mistresses coming out of the woodwork at funerals, conversions, religious, you know, more and more people have recorded messages from beyond the grave that they play at their funeral, or, uh, they've decided that we're having a dance party, or we're having some sort of festivity or an event. I mean, you can do anything these days with a funeral. James: Do you go to a lot, just to observe? Hannah: Yeah, I do my research. So I, I research in death and dying and I, I work at a crematorium and I attend funerals and I hang around with other people in the death care sector. James: Yeah. Hannah: And you do see everything. James: Why do you want to… Tracey: …What got you interested in this? It's your job and I'm just fascinated by it… James: …We'll, we'll, we'll, we'll both do it. I think you've done this sort of thing! So, yeah. Well then, then, why do you want to be around death? Hannah: Oh. I mean, personal and professional. Professional, I'm an anthropologist, and anthropologists want to know what brings us together, what makes us all human, but then also why we do it so differently. And there is nothing else. It is the question, right, it is the one thing we all experience, and yet we've all decided to do it in completely different ways, and completely different ways throughout history. And then, personally, my dad died, and I thought, gosh, what on earth is going on? I suddenly was given the catalogue, of funeral, of coffins, right. James: And you were young. Hannah: I was 22, 23 when my dad died. An age that was perfectly old and mature at the time, I thought. But looking back, obviously, it was incredibly young. But yeah, I suddenly got handed this catalogue of, of kind of coffins, and they all had these really naff names, like, you know, these rich mahoganies, and like, it was like paint colours. Someone had, someone somewhere had decided, these were the options, right, that you were, that this is what was going to represent my dad. And I just felt this massive disconnect and I thought, ‘Hang on, I've got to work out what's going on there.’ So now I spend my life in death, as it were. James: Yeah. I suppose, most of us would think being around death would be a very gloomy kind of thing to be, or way to spend your day. Hannah: It can be very gloomy. But oh my gosh, the gallows humour that those boys in the crem – the crematorium – tell, uh, you know. James: Is there a joke you can share? Hannah: Ooh. Um. Not a lot of them are safe for work or anywhere. James: Tracey, you were going to jump in and ask something there before. What were you going to ask? You know, fellow professional interviewer. Tracey: I really see a connection with you being 22 when your father died and I was 32 when my mother died. Hannah: Mm. Tracey: Even at 32 I felt like I wasn't ready for it. James: Right, no. Tracey: And especially because it happened so quickly. Mum was the linchpin for the family, you know, smart and funny and she could do anything. She was one of those early super women kind of role models. And then all of a sudden at the age of 51 she was diagnosed with pancreatic cancer with seven months to live and she lived seven months almost to the day. And it was blood and guts and gore. She was in agonising pain. My sister and I were injecting her with medication every day. We wanted her to die in the home. Tracey: But it got to the stage where we had to bring her to palliative care, and that's when we started having the conversations about voluntary assisted dying, because, um, Mum and Dad had always said, put me down like a dog. And again, it's one of those things that you think it's going to be easy at the time, but it's not. We talked to the doctor. The doctor said, I don't want to end up in jail. And my sister sat there with the morphine button. She pressed it so often she had a bruise on her thumb. James: Hmm, right Tracey: …we said, surely you can just increase the morphine, because Mum was having breakthrough pain. So everything was fine until she'd scream once an hour, and there was no way they could cap that. So it's cruel, right? It's cruel. I, I don't think there's any way they would have done it. We tried to have those conversations. James: …Yeah… Tracey: Which is why one night, because we were sleeping in a chair next to her overnight just to hold her hand when she was in pain, I picked up the pillow and I did try to put it over her face because I thought, what kind of daughter am I, to let her suffer? And then I stopped at the last minute and then I felt really ashamed of, you know, what a coward I am. Hannah: No, I was going to say the opposite. What an incredibly brave act to, to have so much love and compassion for this person and so much respect, what you knew her wishes would be, that you were willing to do that, you know, for, not – for her, not to her, for her, right? That's extraordinary. Tracey: It's lovely of you to say. James: Did she know what you were doing? Tracey: Oh no, she was out of it for about the previous two weeks, actually. In and out of it. And then she died in the next 24 hours anyway. So she was very, very close. And she'd had that kind of burst, you know, had that almost honeymoon period a couple of days beforehand where you think, Well, she seems like she's getting better and we've read about that, so we expected she was close. Hannah: …Yep, the final, the final burst… Tracey: Yeah. Is there a name for that? Hannah: You know, I don't know what it's called, but you know, that is when usually the palliative care doctors, the hospice workers will call up the family and say, guess what? They're up and about, they're talking, they're eating all of a sudden, and that's genuinely usually a sign that it's not going to be long. James: Wow, isn't that interesting. Hannah: It's the final burst of energy. One of the interesting things about the rise of voluntary assisted dying, of euthanasia, to speak more broadly in Australia, is it reflects this kind of cultural shift that we have about the importance of choice and control towards the end of our lives and how increasingly like that is becoming an important part of what we think about as a good death, right. Like I want to be able to control where I die and who I die with and when and the pain and suffering, right? And that hasn't always been the case, right, you know throughout history there's been periods of that. There's been periods of, ‘Leave it to God.’ Or there's also been periods of, ‘Yes, I must prepare. I have to write my final last note or poetry’, or whatever it is. But that's increasingly becoming important particularly for, we see within the baby boomer generation that they really want to, you know, have some sort of choice, and emphasis on choice. James: Well, I mean, I wonder whether a lot of it is a reaction to, um, the, the medical control over the end of our lives is so extreme that we can be kept alive for so long. And so, it's, it's, it's a reaction to that medical control, isn't it? To want to say, well, surely I can, we can, we can have both, can't we? You can either keep me alive or I don't want to be kept alive. Could you let me go? Hannah: It's one of the great paradoxes, they talk about this paradox of contemporary death and contemporary medicine, is that all of our interventions have increased, right. The medicalisation of death has meant that not only do we have pain control, but we can keep people alive for longer. You know, we have better medicines, drugs, palliative medicine is massively advanced. And yet, if we ask people, the quality of death and dying has not increased. James: Right… Hannah: …And if we look globally, more access to medicine doesn't necessarily correlate with a higher quality of death and dying. There's some correlation, like, do you actually have the drugs? Can you access, access them? But when it gets to kind of over a certain hurdle, just because you're dying in Australia versus dying in a country with no resources doesn't mean you're going to die better. James: What do you, what's a quality of death? How are we measuring that? What do you mean by that? Hannah: There's lots of things you can do to measure it and people try. So one of them is, you know, to ask, ask the family, to ask the dying person, to also ask the physician, did you think this was a good death? You know, how do we assess it? Because it's not just up to the dying person as well. Of course, it's also up to the family, right – How did you experience that death, that dying? It's a difficult thing to measure, right, because for some people death is never gonna be… You know, the words good death, bad death are kind of controversial now because it's like, oh my God, I have to try at everything else, do I also have to live up to a good death? Like, we can't make it good. Can we make it better? James: Yeah. What is a good death, Tracey? Tracey: I think this really intersects with, uh, competition. Everything's become a competition. And also quality of ageing. Hannah: Yes, yes… Tracey: …Because my darling dad, who's 84 and still hanging on after smoking and drinking himself almost to death when he was in his 50s – it's a miracle he's still alive. He has very close to zero quality of life. He's a lovely man, we love spending time with him, but he can barely walk. You know, where's the quality of life? So I've just written a book about artificial intelligence recently, so it worries me, that medtech space, that we're getting people to live longer, but there's no quality of life and also no quality of death. Hannah: There's this phenomenon we actually call, in scholarship, we call it prolonged dwindling. Tracey: Oh, which is so true, I love that. Hannah: What a term! But it's, it's… James: …Sounds like the worst Enya album ever… Tracey: …And it never ends… Hannah: …But yeah, it's, it's, there's exactly this thing, right. So it used to be, if you look at like the kind of time, it used to be that you'd either have a sudden illness, fall off a horse, through a sword, war, back in the day, and you, and then you would die, or you would have a, you know, a serious major illness, like a cancer or a heart attack, and then pretty soon after, you'd die, right? What we have now, what we tend to have now, is these kind of timelines towards the end of life of, you know, multiple hospitalisations, in and out of hospital, or you have something like Alzheimer's, right, where you have a very, very, very slow and long cognitive decline, potentially with very high care needs, so you're in hospital, you're in care for 20, 30 years, right? Which is unheard of previously, that you would need this level. So how we die is changing, and it's a completely different timeline. James: Yeah. Does… Tracey, let's just return to this moment when you started to perhaps really think about death. You know, you're confronting your mother's suffering, and you think about, you know, taking control of that, about doing something. Was that an impulse? Was it something that grew over time? Tracey: It was knowing my mother's character as being very forthright, and she was always in control, to speak to control. She would have liked me to try to control the situation. It was also, obviously, that you never want to see a loved one in suffering. But it taught all of us in the family a couple of important lessons. Dad’s now got an advance care directive that’s 28 pages long, so we know exactly what's going to happen. My husband and I still haven't done that, but we do talk to our kids who are aged 18 and 20 about this kind of stuff. I think part of that is my husband's a camera operator, I've been a long-time journalist, so in newsrooms, a very dark sense of humour, similar to the crematoriums, so we talk about death and dying an awful lot at home, but I think it's important to have those conversations and to prepare for a good enough death as much as you can. Tracey: I mean, what does a good enough death mean to you? Have you thought about that yourself? James: Yeah, well I have. I've had some, you know, health issues, had a cancer last year, and so that sort of thing, you know, you do start to confront it and think about it. I'm the fall asleep in the bed, you know, go to bed one night, don't wake up. Tracey: The classic. James: That's the classic. Give me the classic. I'm happy with the classic. Hannah: …Hopefully after you've just finished penning your magnum opus, surrounded by friends and family. James: The end, you know. For me to be onstage, I've just finished a searing saxophone solo, and everyone's just ‘Amazing! Unbelievable!’ Down you go. Something like I mean, sudden, seems to be, just immediate. Immediate and sudden, no suffering. Hannah: Well, that's the thing. Hannah: People always ask me, you know, do you fear death, are you afraid of death? And frankly, after studying it for this long, no, not at all. And I think in an odd way, there is some kind of horrific privilege of having at least one of your parents die young because all of a sudden, you do start thinking about all these things and you learn to live with death, even if you don't like it a lot of the time. I don't fear death, I do fear the prolonged dwindling. Right, like that, the kind of ageing poorly without support in a way that I can't make the controls, and and you know, can't make decisions. That's much more scary to me than death. Death is kind of a great mystery. James: Your interaction with your mother, Tracey, led you to looking at voluntary assisted dying. What did people say about it? What was the general, when you first started to talk about it, when you first started to campaign for it, what would people say? Tracey: What I noticed was a disconnect, that people in the community overwhelmingly supported this because they’d seen loved ones die. But in our parliaments, I saw there a lot of people, a higher percentage than the normal population, are quite religious in our parliaments. Hannah: …Completely unrepresentative... Tracey: …Unrepresentative. And so a lot of organised religions are pushing back against it and therefore there wasn't an appetite for change because of that. I think it took these wonderful lobby groups to get the politicians to listen and for them to realise that there was a groundswell of support. And also, of course, with the examples in the Netherlands and Oregon and Canada who have quite different laws to us. But very successful laws. You rarely see people, I think it's 99.9% successful – only a tiny amount of people who are abusing the legislation, tiny, tiny – but the rest of it, everyone overwhelmingly aligns with it. So it's done in a very ethical and proper kind of way. James: So do you feel as though when you first started talking about it, really, most people were on board? It wasn't something, it wasn't one of those things where we're really trying to, we had to convince people. Tracey: No, that's right, except for people who were particularly religious. Because, let's face it, everyone, pretty much, unless you're quite young, has had a loved one die, so this is something that affected everyone. James: Yeah. I suppose I was wondering. Like someone, some friend, the other day, you know, how have you been, blah, blah, blah. And he went, ‘oh, I had a weird thing yesterday, like, my uncle died’. And I went, ‘oh, that's sad’. And he said, ‘no, no, it was voluntary, he did the voluntary assisted death. He died yesterday afternoon at two o'clock’, you know. I went, ‘oh, wow, you know, you're there?’ ‘Yeah, we're all there, and, you know, it was great, we had a lovely morning with him. We had dinner the night before, and then it just all took place.’ I said, wow, how amazing. And what I was really struck by was what a normal conversation this was. It was a bit like saying, ‘we went to holiday in Queensland’. You know, like it was sort of, he wasn't describing some outlandish thing, you know, it was suddenly this thing, suddenly voluntary assisted dying was just part of the fabric of our, of our lives. You know, do you feel that that's happened in Australia? Tracey: I do feel it's become more normalised, to your point, over the last 20 years. But there's still a lot of academic debate about at what, at what point should you be able to do it. At the moment in Australia, it's overwhelmingly someone with a terminal illness. And it's done by themselves or their doctor, their practitioner. But there are people who want to bring it in for people who are elderly and, and suffering and don't want to live any longer, to support them there. So we're seeing, I guess, a fragmentation of the discussion and the arguments. And I'll be interested to see which way that goes down the track. There's a lot of debate about people, to your point earlier with Alzheimer's, people who have dementia. Hannah: Sensory pleasures. Like, people being able to taste and smell and touch and hug become really important at the end of life. Tracey: Oh, that reminds me of someone I know who did have a good death, who was my grandfather, Mum's father. He lived until 94, and I cared for him towards the end of his life. Our kids were little then, they were probably 7 and 8. And he had that burst, and they said, come on in, he'll die in the next couple of days. We brought in oysters, we brought in red wine. I brought in the kids because I think it was important for them to see that, and he had a good death within the next 24 hours. So it is possible. I think it's rare, but it's possible. James: Yeah, if you know what's happening. A lot of your speciality, Hannah, is in Buddhism. What do Buddhists make of voluntary assisted dying? Hannah: Well, I will say that Buddhism is a religion with over 500 million people in it. So it's kind of like asking, what are the Christians? James: …Right. Right. Hannah: …or what are the Western people think about voluntary assisted dying? So, a range of views. James: Range of views. Hannah: Really huge range of views. James: I suppose I was just wondering whether there was anything in the Buddhist canon as such or the Buddhist, you know, view that just went, no, let life take its course. That, you know, you must experience suffering, so therefore you must experience all life. Hannah: Well, suffering is pretty important to Buddhism, right? And suffering well, and learning to suffer well, is really important. So there are some Buddhists who would oppose voluntary assisted dying because there's a prohibition against killing, right? But most people in Buddhism will, say, weigh that prohibition against killing against, kind of, the experience of suffering, right, and lessening people's suffering. So certainly there are some Buddhists who would say, no, you know, we need to experience suffering and learn how to experience the suffering at the end of life. And that can be quite instructive. It's also why some Buddhists may, uh, deny pain medication and even, you know, deny anything that kind of clogs their mind, because they want to be conscious at the end of life. They want to experience it all, you know, see where their consciousness goes to the next reincarnation. But there's also a, you know, a massive Buddhist movement that has always kind of seen humanity on quite a similar level to animals, right, that we are all beings of this world, and therefore in the same way that we would, you know, have compassion for the suffering of a pet and, you know, euthanase a pet that's going through unavoidable suffering, with many Buddhists who would therefore support the euthanasia of a human being that's going through suffering, right, in the same way. Because humans are not particularly special, right, we're just another being in this world and we'd want to show the same compassion for both of those. James: Yeah, yeah. Hannah: Huge range of views. James: Yeah. Tracey, you said, you said you're an atheist. Does that mean, you know, once the final curtain falls, that's it? Tracey: Well, I'm one of those very open-minded atheists, James, who, if I am diagnosed with something, I fully am open to the opportunity of religion if I end up needing it at that time. And I imagine a lot of people do that. And if, if I do decide to do that, I would choose Buddhism. Hannah: There's actually a fascinating piece of research that just came out, Professor Manning, a religious studies scholar, and she looked at older atheists and what they think about the end of life. Because we tend to think, well, religious people have beliefs, but we don't really study atheists’ beliefs, right, we just think they all think nothing. But she actually found that there was kind of three different kind of world views or narratives that came out, that can be summarised as: lights out, recycling, or mystery. James: I'm all three. I'm all three. Hannah: So the first one is this idea, it's kind of like – death is like anesthesia, you just, that's it. You're at the end, you know, there's nothing, and it's often very biomedical, right. It's like sleep, but you don't dream, so it's more like anesthesia. You know, we've all, maybe all experienced that, and that's what these people believe, that that will be the end. The second one is recycling. So this is the food for worms idea, right, that yes, I will die, but my, you know… Carl Sagan: ‘We are all made of stardust’, right, we'll go back into the universe and one day I will be an oak tree or a, you know, something, quite, you know, a beautiful idea, which I, you know, I think I subscribe to that, I quite like that. And then the third one that they described around atheists was just mystery. That, for a certain group of people, who knows? And we can't ask anyone. And so that it was, it was almost kind of curiosity and excitement towards the end of life. So there are, yeah, you know, this is quite a great mystery, it's a great adventure, right, that we should all go on. James: Yeah, fantastic. We didn't talk much about, I suppose, the emotion we might feel around death at various points. You know, like, I've observed lots of conversations on the radio where my parents' generation, ‘stiff upper lip’... Hannah: …Stoicism… James: …‘How's she doing? Oh, very well.’ Which means she wasn't feeling anything at all. There's been no, you know, like, that's sort of how you're meant to feel. We now tend to be very emotional about death, you know, like it's, like it's part of our funeral rites, I suppose, to release that, to make sure we all howl. Hannah: Yeah, we have this kind of catharsis model of the funeral, right, which is this idea that, you know, you kind of, even if you might not want to, you go to the funeral and you cry it all out with other people and you have this communal experience of grief. And somehow that is helpful, if not entirely necessary for our long-term grief. But, you know, there's many cultures around the world where wailing is a big tradition, right, so that, you know, women physically throwing themselves at the coffin, howling, collectively crying. You know, it might be an extended period of wearing a certain colour, wearing black, you know, gathering together. Those kind of rituals can also be a way for people to process grief and emotion. You think of, particularly like, you know, in the Jewish tradition of sitting shiva, right, that after someone dies, you immediately gather, right, and there's an extended period of everyone sitting together and dedicated to experiencing grief together. That's quite different to our kind of one-day funeral a week or two after the person's died, and we all go back to our home. Hannah: And it kind of depends on, like, what kind of level of social ties that your cultural society engages in the funeral, right. Do you have a very small private funeral where it's only the immediate family who are the ones that are supposed to be grieving? Or is it everyone you knew in that society, and you have a responsibility to go and be there because you're part of a much larger social fabric, right. And that can be quite different – it can be a 300 or 400-person funeral. You know, one of the largest social groups in Australia is South Asian, Indian, Hindu migration, right? Often extremely large funerals, 300, 400 people in some cases, right, because there's a different expectation about who are the mourners, who is the congregation, who are the people that gather together and stand against death, as it were. Tracey: Another big difference seems to me, and I'd love to hear more about you on this, is the cultures that sit with the body for three days, or have the open coffin for viewing… James: …the body stays at home… Tracey: …of the body, or the body stays at home. Because my sister and I sat with Mum's body for as long as we were legally and practically allowed to in the hospital, which was hours and hours and hours. And when we told a lot of our Western friends, they said what an awful thing to do. But it was really lovely because it cemented the idea that she was actually gone. We told her stories. My sister and I laughed. We cried. It was actually incredibly therapeutic. Hannah: Yeah, and this is one of the difficulties, is people feel, because they have a lot of… People don't have a lot of information, right, so if you're lucky, very lucky, then you'll organise maybe one or two funerals during your whole life, right, and probably there'll be those for your parents, right. And you just don't have a lot of information because we don't talk about it. So you don't know what you're allowed to do. But you know, in all states and territories across Australia, you are allowed to be with that body for an extended period of time. You're allowed to bring that body home. You know, you can actively resist pressures from the hospital and the hospice and everyone else to get you out the door. You can say, no, I would like to be with this body for a bit longer. And as you say, there is also technologies that can allow you to bring the body into the home. I mean, the reason we call them funeral parlours is the front parlour of the house. That is the room where we used to display the body and be with the body and that still occurs in many cultures around the world. You know, it's difficult; it can be difficult. It's not always the right decision, you know, you have to think about your particular circumstances, but it is possible. James: Yeah. Well, thank you so much. Any final words? Tracey: Only that I think we should all choose our own funeral soundtrack. I've been doing that with a girlfriend lately. James: …What's she gone with? Tracey: …Because, you know… well, I've gone with Edith Piaf. Hannah:…Ah, classic… Tracey: …‘No Regrets’, of course. Absolute classic. And my friend is still choosing from five. But I think, otherwise someone else gets a choice, and they might choose something terrible. James: Yes, no, I think that's very important, get your, get your, get your funeral songs sorted out… Hannah: Catering, funeral songs… James: …the whole soundtrack, the catering you'd be concerned about, you want everyone to have something… Hannah: … delicious. James: …any special cheeses or wines you want? Hannah: French. Yeah, this is what we did for my dad as well. It was like red wine, good French cheese, baguettes, you know. If you're going to grieve, if you're going to cry, you need some sustenance to support you. Tracey: Comfort food. Hannah: Comfort food, exactly. James: Yeah, very nice. Tracey: Before we let you go, what's your funeral song? James: Do you mean, what do I want people to hear as the coffin's going out or something like that? I don't know if I've made that choice yet. I don't know. Hannah: Hard rock? Tracey: Jazz? Hannah: Pop? James: No, it'll be something jazz, I guess, or something in that tradition. It's probably none of the Frank songs. Tracey: Something majestic, though. James: So yeah, ‘Zadok the Priest’, Handel… Hannah: …Oh, I like that. Old school. James: …Something huge! I haven't decided. Yeah, it's, it's but you're right. Like everything, do it, put some effort into it, you know, and have all that stuff ready for your children, for those that are going to have to do it, a little folder somewhere. Tracey: You could play some of your television clips from over the years. James: Oh, I don't think so, Tracey. I think yours might have something like… Hannah: …a highlights reel… Tracey: …a showreel! James: Yeah, my showreel. No, let's not do that. It's largely children's television, Tracey. No one wants to see that. Tracey: That would be great at a funeral. James: I could conduct a – I'd like to conduct a beyond-the-grave talkback session, probably, talkback radio or something. That could be very fun. Hannah: People could all call in to your funeral. James: Oh, I love that! Tracey: Interactive funerals! James: It's a ‘simil’ funeral. It's being broadcast on the station and then people can call in with their tributes. Oh, that's good. Hannah: Anything is possible. James: That is good. Okay, we've got it. Thank you for helping me sort that out. Hannah: We've done it. James: Well, thanks so much to our guests, Dr Hannah Gould and Tracey Spicer. You've been listening to Season 6 of Life's Booming, Dying Well, brought to you by Australian Seniors. Please leave a review or tell someone about it. If you want more, head to seniors.com.au/podcast. May your life be booming. I'm James Valentine.See omnystudio.com/listener for privacy information.

Let’s talk about death, baby From breaking the stigma to understanding the conversations we need to have before we die, beloved broadcaster and advocate Andrew Denton and clinical psychologist Dr Kerrie Noonan dissect everything we should and shouldn’t say about death. About the episode – brought to you by Australian Seniors. Join James Valentine for the sixth season of Life’s Booming: Dying to Know, our most unflinching yet. We’ll have the conversations that are hardest to have, ask the questions that are easy to ignore, and hear stories that will make you think differently about the one thing we’re all guaranteed to experience: Death. Featuring interviews with famous faces as well as experts in the space, we uncover what they know about what we can expect. There are hard truths, surprising discoveries, tears and even laughs. Nothing about death is off the table. Andrew Denton is renowned as a producer, comedian and Gold Logie-nominated TV presenter, but for the past decade he has been devoted to a very personal cause. He is the founder of Go Gentle Australia, a charity advocating for better end of life choices that was instrumental in passing voluntary assisted dying (VAD) laws across Australia. Senior clinical psychologist Dr Kerrie Noonan is director of the Death Literacy Institute; director of research, Western NSW Local Health District; and adjunct Associate Professor, Public Health Palliative Care Unit, La Trobe University. For the past 25 years she has been working to create a more death literate society, one where people and communities have the practical know-how needed to plan well and respond to dying, death and grief. If you have any thoughts or questions and want to share your story to Life’s Booming, send us a voice note – lifesbooming@seniors.com.au Watch Life’s Booming on YouTube Listen to Life's Booming on Apple Podcasts Listen to Life's Booming on Spotify For more information visit seniors.com.au/podcast Produced by Medium Rare Content Agency, in conjunction with Ampel -- Disclaimer: Please be advised that this episode contains discussions about death, which may be triggering or upsetting for some listeners. Listener discretion is advised. If you are struggling with the loss of a loved one, please know that you are not alone and there are resources available. For additional support please contact Lifeline on 131 114 or Beyond Blue on 1300 224 636. TRANSCRIPT: James: Hello, and welcome to Life's Booming. I'm James Valentine, and this season, we're talking about death. Or, on this episode, why we don't talk about it enough. Death is really easy to talk about, but avoiding the subject just makes things even harder. From breaking the stigma to understanding the conversations we must have before we die, I'll be dissecting everything we should and shouldn't say about death with two fascinating minds. Andrew Denton is the founder of Go Gentle Australia. A charity advocating for better end of life choices, but you probably know him better from so many shows on our TV. And Dr Kerrie Noonan is a senior clinical psychologist and social researcher, determined to increase our death literacy. Kerrie, Andrew, thanks so much for joining us. Do you know one another? Andrew: Yes we do. Yeah. Kerrie: Yeah, along the way. Andrew: We've had a few conversations about death, dying, literacy, all those things. Yeah. James: How did you learn about death? Like when did you, and who did you go to talk to? When did you start thinking about it? Andrew: Well, I think you learn about death the way everybody does, which is you experience it. And the first time it happened to me, I made a documentary about teenagers with cancer, Canteen, the support group, and one of those young men died. And his parents very generously invited me to visit him as he was dying. And that was the first time I actually saw what death can be. And it was, it was very hard to see and then watching my own father die obviously was a profound moment for me because that was an unhappy death. But how I've learned about it since is, I imagine a bit like Kerrie. I've had thousands of hours of conversations with people who are dying and their families and their carers. And, I've learned so much about death I feel I've mastered it and can move on. James: Yeah, true. That's right. Is that, is this what you mean by death literacy, that, that in some ways we just need to be talking about it more? Kerrie: It's, it's talking about it. That, that's one aspect. But it's, it's kind of developing your know-how and being able to put that know-how into practice. So, you can maybe talk about, maybe have some competency in terms of talking or maybe doing one element, related to death and dying. But, when you put it into practice, that's when death literacy kind of really comes to life. It kind of sits, some of the research we've done recently, it's evident that death literacy sits in networks, in-between people, within people, in communities, so it's not just about individuals. James: I suppose I'm wondering about at what point we might have this, or there'd be a difference in death literacy with 20-year-olds than there would be with 80-year-olds, right? Kerrie: Yes, experience changes your death literacy. That's probably the strongest predictor. So we started this research looking at networks of care and how people kind of come together. And so where we're at now is we're looking at what are the predictors and what are the things that we understand so that we can understand more about how to make more death literacy, I guess. So an example, that's your question, well I can give a real example. When my mum was in hospital, we were, we needed someone to help us to move mum from the hospital to home because we wanted to take her home. And we couldn't get the health system or the medical system to do that. So I put an email out, a text message out to my friends who happened to work in the death space. And within an hour we had someone, within two hours, mum was home. And so. That took, you know, that set off a little chain of conversations, emails, texts. And while I was doing that, my brother was getting the medication sorted and other things sorted for my mum. So we really, we utilised, to bring my mum home, we utilised like every bit of knowledge and our networks to do that. James: But you were at the centre of, you know, you, you study this, you're a, you know, an advocate for it, and so you're at the centre of it. You would have a network. I mean, I don't know that I've got the same network. I'd, I could put it out to my friends and they'd go, we could bring wine. Oh, you know, like, I don't know that they'd, I don't know that they'd be that practical. Kerrie: But that's actually helpful too. You need your friends to turn up with wine and, and bread and whatever comforts. So we found that younger people, for example, so we've done two kind of national studies just to kind of demonstrate your point about younger people. Between, 2019, pre COVID, and 2023, we looked at the population and we looked at death literacy and how it changed. And we found that voluntary assisted dying and COVID had an impact on people's death literacy, particularly for the younger people, anyone who's experienced a death, anyone who's been through loss, has higher death literacy than people who haven't. And so, there's lots of things that contribute to that, but, COVID, I think, we're still kind of looking at the data, but certainly voluntary assisted dying because of the way that you need to kind of have conversations, you need to actually reach out to your networks, you need to talk to doctors, you know, there are actually lots of interactions in that that really stretch your skills and, your understanding. James: It's only a few generations back when death was very present in our life. The conversation about voluntary assisted dying has perhaps allowed us to have that conversation again. Have you seen that? Andrew: Yeah, I think that's right. I mean, there's, there's a lovely, witty observation that in Victorian times they talked about death all the time and never about sex. And today it's the other way around. It's not that many generations ago where the body would lie in the house and there'd be a viewing in the house. And so it was, it was a more human thing, the way Kerrie's describing her friends helping her mother come home, that's a communal and human thing. And when I talk about voluntary assisted dying, I must and I want to bracket it with palliative care, because really, despite the fact politically they were oppositional during the legislative debate, they're very much on the same end of the spectrum, which is we're all going to die, and the concept of palliative care, which is also the same idea of voluntary assisted dying, is not, ‘Let's get you to the dying bit, but how do you live as well as you can while you are dying?’ And that dying process could be very short or it could be very long, it could be several years. You, usually you can't be really clear. So the whole point as Kerrie said about voluntary assisted dying and palliative care is you talk about these things. And interestingly, I think there's a paralysis around death, and you know, you said, well, my friends wouldn't know what to do, they'd bring wine, as Kerrie said, that's no bad thing. But if you put out a call to your friends to say, I need to move my fridge, somebody's going to say, I've got a ute. James: Yes. Andrew: …your need, perhaps, to leave hospital and go home, that's the same question… James: They might have a ute. Andrew: …It's just, it's just a human question, which is, I need help. And not only do we get paralysed in the face of death and assume that the experts have the answers, but the experts often get paralysed in the face of death. They don't know how to have those conversations either. So one of the things that voluntary assisted dying absolutely has done, and there was a, a geriatrician in Victoria who said to me. He was ashamed to admit that voluntary assisted dying had made him understand how limited his practice had been, in that he had subconsciously only been asking questions of patients that he had an answer to: How's your pain? James: Right. Andrew: I can treat your pain. What are your symptoms? I might be able to treat your symptoms. Whereas what he asks now is, how do you feel? What is life like for you? That's a much more holistic question. What is it that you need? If we can't help you with it, maybe someone else can help you with it. So I think it's about transcending that paralysis in the face of death. Which is natural, but the greater group that you can talk with it about, the better. I still remember a woman I met several years ago. And she said to me from the moment her husband was diagnosed with cancer to the moment he died, he refused to talk about it. And the, it was like a sliver of ice stuck in her heart because she was frozen in that too. James: Yeah, yeah. Kerrie: Yeah, and I think what we, what we found in a lot of our research too, Andrew, was that, carers were often, had massive networks that the person who was dying didn't know about… Andrew: Right… Kerrie: …as well. So I think that's, that's the other thing, about some of these conversations is that, once you know that you've got community who's up for the conversation or up for whatever around you that a lot of carers are, can have that access to other people. James: And you mean the person dying doesn't know because they don't ask, unless they're talking about it, then no-one thinks to bring it forward? Is that what you mean? Kerrie: Yeah. I think what happens in that situation is a carer can become quite isolated like the dying person. If they don't want to talk about it, there actually are still practical things to organise. There are still things, where are the passwords? How do you get into the bank account? What bills need paying? Andrew: I'm trying that with my wife all the time and she's not even dying! Kerrie: That's right. They continue but you don't get to have the conversation with the person. Andrew: Actually, Geraldine Brooks, a beautiful author, her husband Tony, who is a friend, he died very suddenly, dropped dead in the street, and he was young, in his early 60s. And she's just written a book about this called Memorial Days, about that whole experience. And that's the strongest piece of practical advice she gives, which is, prepare for your death by helping others. James: Yes. Andrew: Like, leave the passwords, explain how these things work. The best things I've learnt about the idea of preparing for death and thinking about death, actually I'm pretty sure came from some of your literature, Kerrie, which was the idea of an emotional will. And an emotional will is not about, to you James, I'll leave my ute. It's actually about, to you James, I'm going to leave, my favourite city in the world. Limerick in Ireland, and here's some money for you to go there, or to you James, I'm going to leave these five songs, which mean something to me. It's actually about, well this poem, it's about gifting something of spiritual life value as opposed to an object. James: Yeah. Following the, the, the legislation in New South Wales, now pretty much in every state, Andrew, where, what do you see now? What do you see in our society now? What do you see happening? Andrew: Look, there's still the same paralysis and fear about death. I think that's, that's kind of natural. You know, one of the people on our board of Go Gentle is the former federal president of the AMA, who's a neurosurgeon, and he said when his dad was dying in hospital, he was afraid to ask for, you know, more help because he didn't want to be annoying. So, you know, I mean, this is the head of the AMA. To me the big question is not so much, how individual families or individuals respond even though it's very important. To me the big conversation is within the medical professions. And I don't actually say that critically. Because we're all equally struggling with the concept of the abyss. And I think, it is an acknowledged problem in healthcare, of futile care at the end of life. It's giving a 90-year-old a hip replacement, for example, just over-treating. Because of the, I've heard it described as ‘doctor as hero’. You know, we give, we give doctors, quite reasonably, a special place in our society. Because we ask special things of them. But part of that training is, we must win. We must treat. When I was first told this by a doctor in Oregon, when I went there. When they said, oh, we see death as a defeat, I actually laughed. I thought they were joking. I said, it's… James: You know you can't win. He turns up with that scythe at some point. Andrew: So I think there's a much broader conversation about what is dying, and how do we have that conversation with people who are dying. And I think… James: I suppose I just thought, I have had a couple of conversations recently with people who have a relative or parent who has gone through voluntary assisted dying… Andrew: Yes… James: …And what I noticed was the way they talked about it, in a sense, wasn't much different to, oh, we went to Europe. You know, we had a nice trip. Like, it was very normal, the way they said it. They went, I was at my uncle's death yesterday. Andrew: It can be. It can be. You know, dying affects different people differently. There are people who have gone through the voluntary assisted dying process who totally support it and are very glad it's there, but still found the experience traumatic. It's not a silver bullet. James: Right. Andrew: It doesn't, it, it's merciful, and it's peaceful, but it doesn't, it certainly doesn't remove grief, and it doesn't remove, for many people, the unreality of dying. We hear many, many testimonies of families deeply grateful for the way in which they are able to say farewell. And I think that's a very important part of voluntary assisted dying. A genuine ability to say farewell. But people are different. There's one man that insisted, who used voluntary assisted dying, and insisted that he be only with his doctor. And the reason he gave, which I find both beautiful and heartbreaking, he said, ‘I don't want the love of my family holding me back’. So, you know, I always maintain when I talk about this. James: [sigh] I felt the same thing. I did the same thing. I know. You know, huge. Andrew: Whenever I've talked about this, I've always maintained, none of us know how our dying will be. All we know is that it will be hours and hours alone. And I think that's why I struggle with, that philosophy that somehow or other, that, our dying is about society at large or about some universal rule that we might be breaking if we don't do it the right way. James: Kerrie, you know, I sort of want to acknowledge that you've been through death quite recently, that your mother died only a few weeks ago as we're having this conversation. As someone who's then spent their life studying this area and thinking about this area, what have you learned from the death of your mother? Kerrie: It looks similar to what Andrew said before about his colleague, the doctor. Like, well, I went straight to the practical things, didn't I? Like, it's a kick, grief's a kick in the guts, let's face it. Knocks you on your butt. James: And we are very practical in those first weeks, aren't we? At the moment of death and afterwards. Kerrie: Just the other day, when we dropped my daughter off to uni, I went to text my mum, as I would usually do. And text her the photo of her in her dorm. And I think this is, you know, I was really glad of my experience because I just sat there and cried for about five minutes, actually. I just needed to blubber and cry. I could have sucked it up. We could have just, you know, driven on. But actually it was really helpful just to really deeply acknowledge that moment. That was the first time. That I'd experienced that real sense of wanting to, to, communicate with her. Andrew: I hope it won't be the last time you hear her cry about your mum. Kerrie: No, it won't be. It won't be. But when she died, because of the work that we had done, I didn't cry initially. Andrew: Yeah. Kerrie: And this is this individual kind of experience of going through this. I didn't, immediately cry. I felt intense relief for my mum. And so I was just reflecting on that. I was like, ‘Whoa, I'm not crying’. The other thing that is, is on my mind is that it took an ICU doctor on the day that mum… So mum had three MET calls. And if you don't know what a MET call is, and you're listening to this, this is where every registrar, every emergency person on call, runs to the bed of the person who is, who's crashing. James: Right. Kerrie: …and she had three of those. And by the end, I'm glad I wasn't there because I hear that mum was very distressed. James: Right. Kerrie: And it took an ICU doctor to sit down with her and go, what do you want Maureen? James: Yeah. Andrew: Yeah. Kerrie: And mum said, I'm done. And so it didn't matter that I'd done that with the doctors, multiple times, or that she had an advanced care directive, clearly stating, do not give me, treatment that will prolong my life. It didn't matter that all of those things were in place. What mattered, was that ICU doctor who absolutely, compassionately just stopped everything and talked to my mum. And it's a pretty brave thing when your heart is failing and other things are happening in your body to say, no more, I'm done. Because that does, that's a decision about you only have a certain amount of time left in your life then. So, that doctor changed the course of my mum's dying. And, yeah, I'll never forget that. And then the compassion at which she called me to talk with me about what mum had decided. And the checking. The difference – one of the other things that I found – the difference between a doctor with really, like, person-centered communication skills and someone who's focused on getting the job done. They ring and say, ‘Hey, I'm caring for your mum. I'm caring for your person. What do you understand about what's happening?’ James: Right. Right. Kerrie: And every time, they did that… James: …they want to listen to you first, yeah. Kerrie: …Yeah. Every time they did that, it just gave me an opportunity, even though I know this gig, I've talked a hundred times on the other side of that conversation with people, but it just made me realise the just incredible, that empathy, you feel it in your bones on a whole other level when someone is truly going, ‘Tell me, tell me your story, tell me your bit.’ And, that was, that was a big learning and a big reflection as a health professional, as someone who's been there. The other thing, sorry, you cracked that open, didn't you? The other, the other part was, no one asked, me or my brother, about, about our experience, our previous experiences, and who we were, and what we did, and who were these children taking their mum home. My brother's a nurse. I've worked in palliative care for a million years, and it was a really interesting thing having to, like, I just wanted someone to go, Hey, have you done this before? And maybe I'm being a bit biased there because that's something that, because I've got a death literacy lens over things. And I'm always interested in, Hey, what have you done before? Hey, what experiences do you want to bring to this one? What do you know about what you're facing? What do you want to know about next? They were all the questions that I would be asking if I was working with someone. I really wanted someone to ask me those questions. Andrew: In a palliative care setting, you would probably have been asked those questions, you would hope. Kerrie: I hope so. Andrew: In a general hospital, maybe not. I think that speaks to two things, what we're talking about, which is paralysis in the face of death and, a sense of we just treat, we treat, we treat. This is what we do. Everybody's terrified of being accused somehow of not having done enough. So I think there's that. And, the doctor, the ICU doctor you described, that strikes me as a perfect piece of medicine. And it, it absolutely accords with what a beautiful nurse said to me in South Australia some years ago. She was very emotional. She was, she was recording a piece for us about why there should be voluntary assisted dying. It was always instructive to me that the ones that really advocated for it were the nurses, because they're the ones that see the suffering. And she just said, ‘Why can't we do the right thing, human to human?’ And that's why I see this as a multi-generational discussion within the health profession. It's not that people in the health profession aren't humans or don't get that, but it's not how they're trained. And, but I also think it speaks to the pressures on the health system too. Kerrie: Yeah. Andrew: In the same way as we're talking about aged care, even though we have a much healthier health system than, say, America, it's still pressured. And we know, we hear stories from hospitals all the time of, resources that are built but not used or resources that are used but are stretched beyond reason, and so I think it's a reflection of all those things. But there was at times, and I think sometimes we don't talk about this enough, is paternalism in healthcare. Andrew: Can I explain that?! James: Yeah, that's right. Andrew: Sorry. James: Oh yeah, we covered that Kerrie, us blokes know all… Andrew: Please, do go on. Kerrie: Oh, there's a lived experience. [laughter]. Oh, yes, that. Andrew: No, I'm sorry, please do explain. James: …which you ably demonstrated… Kerrie: So, that, yeah, like paternalism, we just don't have a critical kind of conversation about paternalism in healthcare. And there's, you know, there's that difference between really great care. And then, but if you just kind of tip it a little further into ‘Hmm, do you really want to do that? Oh, don't you want to be the daughter, not the carer?’ You know, like there are, there are kind of, there are particular things that happen in healthcare that, that we don't, we aren't critical enough, is what I'm saying. I don't know what the answer is, but I would like the system to be more critical about, about some of those things that perhaps they take for granted a little. And, look, sometimes it would be maybe permission for a family to kind of, yeah, be the daughter. James: Well, even in my experience, my cancer experience in the last year or so, I've now done several talks at doctors conferences and things like that. And what, what sort of strikes me as funny about it is I go, ‘We’re thinking of taking an interest in the patient's perspective, perhaps you'd like to come talk about that?’ Patient's perspective. Is this new? Andrew: You know, I, I went on Q&A, about VAD quite early in my advocacy, which was a terrifying experience, by the way, and, and there was a, another fairly prominent doctor who was strongly in opposition, and I, I completed what I had to say by basically saying, you know, doctors, it's, it's time to listen to your patients. And this doctor, who's a very good writer, wrote this excoriating piece in a magazine afterwards, just accusing me of being patronising towards doctors. And I'm thinking, that's patronising? I mean, the worst example I know of this, there was a, a former AMA official and, they held a debate on this internally in 2016, that I had a link to and I, so I watched it. And he was a, a geriatrician, and a senior doctor. And somebody on the other side of the debate, because he was opposed, had put to him that there's a great public support for this. And he said, and I'm, I'm quoting pretty close to verbatim, he said, ‘That's why we're paid $200,000 a year. We make these decisions.’ And that's, so I think there is significant paternalism. There was another, a female oncologist who wrote a piece in The Australian against these laws, and even though it wasn't her headline, it was what she meant. The headline was, ‘Autonomy, it's not about you’. And you know, going back to what I was saying, there cannot be a more, you-focused experience than your dying. I don't care what your religion tells you, in the end, only you are going there when it happens. James: You've given, is it a decade now, to this? Andrew: More, I think. James: More, you know. Again, I suppose, what's your reflection on that? I sort of feel like I'm framing the question almost, are you glad you did that? You know, is that… Andrew: There are times, and I'm sure Kerrie would agree with this, there are times I think, you know, I've had enough death, thank you very much. Andrew: But I would have to say it's been the most brilliant second act for me after showbusiness, far more meaningful to me. The correspondence I've had and the conversations I've had, have been so privileged, and the gratitude that we as an organisation, Go Gentle, receive from people whose families had the option of voluntary assisted dying is immense. And, so yes, I am glad. And certainly I view this as the real work that I've done, not whatever I may have done in television. Perhaps if I'd won a Logie, I'd feel differently about that. James: I think you peaked at [1980s show] Blah, Blah, Blah, quite frankly! Andrew: Yeah, I think so, and it was all downhill after that first year, exactly! James: Yeah, well, I almost feel like I need to go and have a good cry. It's been, a beautiful discussion. Thank you so much for, uh, sharing it with us here on Life's Booming. Andrew: Can I ask you a question? Before you just wound up, you're getting teary. James: Yeah, yeah. Andrew: What are you feeling? James: I'm taking a deep breath to calm, so I can't talk, not necessarily to squash it. I'm always surprised when it comes up. I, I never quite know when I'm going to get teary. And sometimes it's, it can happen on air, like sometimes if someone starts talking about death or a relative, and I'll be listening to it and I'll suddenly go to speak and go, oh, the emotion's right there, you know. So, I'm not entirely clear. I think I'm moved by Kerrie, and sort of wanting to experience your grief in some ways, deal with that. Or I feel like, I think I'm feeling that you, you holding it in, sort of that, you know, we need to sort of let that, let that go a bit. So, it's interesting. I think I'm moved by your work as well. Look, we have a funny connection over many decades, and to observe you go through, deal with, deal with, you know, to see you transform into doing that work has been quite extraordinary. And I'm probably just contemplating my own death. [laughter] Andrew: And, exactly right, James. And during the height of COVID, quite unexpectedly, a very good, friend of mine, he rang me from Victoria and we knew his wife had pancreatic cancer, which is obviously a very tough diagnosis. And then he said she's chosen VAD and she's going to die in this state. And despite all the thousands of hours spent in that debate to get that law passed in Victoria, which was the first one in Australia, and it was an absolute brutal knife fight of a battle to get that law passed. For some reason, it had never occurred to me that somebody who I knew and loved was going to use this law. James: Yeah, right. Andrew: And I remember, despite everything I knew about it, on the day, Jennifer and I, we got our whisky glasses. We poured a whisky. We lit a candle. But I remember thinking as the clock ticked down to the moment, it felt very unreal to me. But the strong emotion that I felt at the moment, knowledge in the moment of her dying was not that she had died. It was actually about just the richness of life. Oh my god, life is so rich. And that's what I felt. I just felt, wow, life. Kerrie: I think that is what you say there is so deeply important because one of the reluctances around talking about death and dying is not being able to maybe lean into some of that feeling around that richness of life. When we were going through photo albums, there were photos there that, you know, that we'd never really taken notice of before. Damn, we wanted to know about them now. Who were they? Who are these people? Where are they now? It does connect you to life in a very profound way. And all of the messiness of that. And that's, I think, only a great thing. Watching my children, 22 and 17, be with their grandma. We did a very, a simple thing. Put a comb, a brush on the end of her bed. And mum used to love having her hair brushed. And we just said to the kids, just brush her hair, if you want. Andrew: That’s gorgeous… Kerrie: And so that just very simple action just then gave them something to be with her while she was dying. Andrew: Human to human. James: Yeah. Kerrie: Yeah. And my children did that many times, while she was dying. And, and that's when we would sit and talk about what we did with Nanny and things. And we, you know… So it's worth leaning into. I guess that's the other thing. It's worth getting the whisky out and having a think about, about, about these things and reflecting in on it, and how, and what it means to you and what you want to do. James: Thank you. Kerrie: Thanks. Andrew: Thanks, James. James: I'm gonna cry. Andrew: Come on. Let's hug it out. Come here. James: Exactly. It was very good. That was a beautiful moment. Thank you. Thank you. Thank you. Thanks to our guests, Andrew Denton and Dr Kerrie Noonan. You've been listening to Season 6 of Life's Booming: Dying to Know, brought to you by Australian Seniors. Please leave a review or tell someone about it. Head to seniors.com.au/podcast for more episodes. May your life be booming. I'm James Valentine.See omnystudio.com/listener for privacy information.

Join James Valentine for the sixth season of Life’s Booming: Dying to Know, our most unflinching yet. We’ll have the conversations that are hardest to have, ask the questions that are easy to ignore, and hear stories that will make you think differently about the one thing we’re all guaranteed to experience: Death. Featuring interviews with famous faces as well as experts in the space, we uncover what they know about what we can expect. There are hard truths, surprising discoveries, tears and even laughs. Nothing about death is off the table. If you have any thoughts or questions and want to share your story to Life’s Booming, send us a voice note – lifesbooming@seniors.com.au Watch Life’s Booming on YouTube Listen to Life's Booming on Apple Podcasts Listen to Life's Booming on Spotify For more information visit seniors.com.au/podcast Produced by Medium Rare Content Agency, in conjunction with AmpelSee omnystudio.com/listener for privacy information.

Many of us put off creating or updating our wills, often because it feels like it's something that can be addressed later. But life is unpredictable, and having a current will is vital to protecting your loved ones and reflecting your wishes when the time comes. In this special episode, host James Valentine speaks to TV personality and keynote speaker Barry Du Bois about his very personal story, and hear from Safewill CEO and founder Adam Lubofsky about the importance of securing your legacy. About the episode - brought to you by Australian Seniors.  Join James Valentine as he explores the incredible stories of Aussie characters, from the adventurous to the love-struck. Across 31 inspirational episodes, Life's Booming explores life, health, love, travel, and everything in between.  This special episode commemorates Australian Seniors inaugural Update Your Will Day on 20 October, and reminds Australians of the importance of protecting your legacy for the ones we leave behind. In 2011, keynote speaker and former The Living Room presenter Barry Du Bois sat in front of a team of doctors and heard the immortal words: it's time to put your affairs in order. Facing a cancer diagnosis, he turned his attention to securing his legacy for his family. Safewill founder and CEO Adam Lubofsky created his online platform to help Australians simplify the process of writing and updating their will. He shares some of the common will myths and reminds us all of the importance of regularly reviewing your will to ensure your estate plan is current, legally valid, and reflective of your intentions.  If you want to share your story to Life's Booming, visit seniors.com.au/podcast. Watch Life's Booming on Youtube  Listen to Life's Booming on Apple Podcasts  Listen to Life's Booming on Spotify:  Listen to Life's Booming on Google Podcasts  For more information About Australian Seniors visit seniors.com.au/podcast. Produced by Medium Rare Content Agency, in conjunction with Ampel Sonic Experience AgencySee omnystudio.com/listener for privacy information.

Here we delve into another aspect of our health that is often less spoken about: mental health. Older people are more likely to experience contributing factors to depression and anxiety, such as physical illness or personal loss, but how many seek help? In this episode, comedian Mary Coustas (aka Effie) shares her very personal story, and we get insight from clinical psychologist Dr Charlotte Keating on how to better care for your mental health. About the episode – brought to you by Australian Seniors.  Join James Valentine as he explores the incredible stories of Aussie characters, from the adventurous to the love-struck. Across 30 inspirational episodes, Life's Booming explores life, health, love, travel, and everything in-between Our bodies surprise us in ways we never thought possible as we age, so in series five of the Life's Booming podcast – Is This Normal? – we're settling in for honest chats with famous guests and noted experts about the ways our bodies behave as they age, discussing the issues and awkward questions you may be too embarrassed to ask yourself. Mary Coustas is one of Australia's most loved actors, comedians & corporate speakers. In 1987 she became a member of the ground-breaking stage show ‘Wogs out of Work', where her comic creation Effie was born. She is about to embark on a national tour, called UpYourselfness.  Dr Charlotte Keating is a clinical psychologist with a PhD in neuroscience, who runs her own private practice in Sydney's Lower North Shore. She is a passionate advocate for everyone's mental health, and has a particular interest in helping executives, parents, and young people. If you have any thoughts or questions and want to share your story to Life's Booming, send us a voice note - lifesbooming@seniors.com.au. Watch Life's Booming on Youtube  Listen to Life's Booming on Apple Podcasts Listen to Life's Booming on Spotify Listen to Life's Booming on Google Podcasts  For more information visit seniors.com.au/podcast  Produced by Medium Rare Content Agency, in conjunction with Ampel Sonic Experience Agency   Transcript: James Valentine: Hello and welcome to Life's Booming Series 5 of this most excellent and award winning podcast. I'm James Valentine and in this series we're going to ask the question, is this normal? I mean, as we age, stuff happens to us. Our bodies change, things fall off, we get crook, stuff doesn't work as well as it used to. There's nothing we can do about it, we're getting older, we're ageing. But which bits are normal? Which bits do we have no control over? Which bits can we do something about? That's the kind of questions that we're going to be asking in this series, Is This Normal? of Life's Booming. Now, of course, if you enjoy this series, leave us a review, tell all your families and friends about it. And we want to hear from you as well. You can contribute to this. If you've got questions about things in particular that you want to know, perhaps there's some particular wear and tear happening to you, let us know. We'd love to see if we can answer that question in the series. We're going to look at things like menopause, gut health, mental health, lots of other burning questions. So think about those areas. And if there's something in there that's specific to you that you'd like us to cover, let us know. On this episode, we'll delve into another aspect of our health that is perhaps less spoken about, zeroing in on mental health. We'll be speaking to clinical psychologist Dr Charlotte Keating, who is currently practising in Sydney. But first, let's introduce someone you might know as Effie, comedian Mary Coustas. Well, hello. So we're going to talk some mental health. We're going to talk about these kind of things. What affects you as you get older, how you deal with it as you get older, what changes. What have you noticed, Mary?  Mary Coustas: Here's the thing. I love contrast. I love contradiction. I like all those things that when put together make for a more interesting mix. You feel more yourself, obviously, with age. You've worked through what matters and what doesn't, and hopefully you've found a healthy place to put what you've learned, either in practice or out there into the world. And I do it through laughter, mostly. But your body goes through something else that you should have anticipated, but you didn't. So I found the whole menopause thing really tricky, particularly for me, because when I was going through perimenopause, I was doing 10 years of IVF. So it was hard for me to know that I was going through perimenopause because I was taking IVF drugs, to have my now daughter. So then I missed that. And then I was much later, I came to motherhood late. And so then after I gave birth to my daughter, I was going through menopause, but you think because women are so accustomed to discomfort – and I'm not talking about marriage – sometimes it's that we don't connect the dots enough. So I thought it must be because I've just become a mother and the hormones from that, and I didn't realise it was the menopause thing. And the menopause thing plagues us in many different ways, but mentally it's a big one. It was the biggest one for me.  James Valentine: Before that, I mean, it's a bit of a cliche to say that the comedians are often doing that because of anxiety, because of various mental health issues. Were you that? Is Effie the outcome of that? Mary Coustas: No, I mean, yes, I had anxiety. I had a dying father. That doesn't help. Like he was unwell from before I was born. So that was the only true anxiety, apart from the racism that I encountered and then turned into a career.  James Valentine: Yeah. You mentioned that, like, Effie's a response to racism. I suppose I hadn't quite realised that. Explain how that came about.  Mary Coustas: Well, I was very confident growing up in a working class multicultural suburb. And then we moved as a family. My dad was very much a bigger picture sort of guy and said, we need to go where you can get a better education. And unfortunately that was in a very white area and I was the little seed. From the multigrain that made it into a very wide area. And I was spotted immediately. You know, everything about me. I was very into fashion. I had my Suzi Quatro haircut. I was on it. I paid a terrible price for that. For being different.  James Valentine: How old were you? Mary Coustas: I was nine. And it peaked I think a year or two in, and I just couldn't find a way to make it work for me. I was ostracised and it was tough. It was very, very tough because it was coinciding with my dad's health. And it was a very defining moment for me. And I hated the suburbs. I still get a little bit, oh god, I've got to get back to the inner. Because I feel like that's where we celebrate togetherness a bit more. We don't drive up a driveway and close the garage door and say goodbye to the day and everyone around us. I don't like that isolated feeling. So, the minute I stood on stage during my high school years, in musicals, which is ridiculous, I don't sing at all, but I mime brilliantly, I just went, okay, this is my stage, and this is where I can express myself. The Greeks built this thing thousands of years ago and they knew something and it's my thing and because I love the older generation so much and their stories, and this is beautifully folding into the conversation that we're having. I was never bored with that generation and what they'd experienced in their village stories and how they came to Australia and what that was like for them. So the marriage of that obsession with the older generation, with finding a healthy outlet to express the big noose that was hanging around my social neck, which was race, Wogs Out of Work happened.  I served Nick Giannopoulos as a waitress. He just graduated from acting school and so had I. I didn't know him. But then he told me, we went to the same primary school, the same Greek school. I mean, it was just so bizarre. And then Wogs Out of Work happened and that was the thing that changed the conversation in Australia. It was such a humongous stage show that really addressed the elephant in the cultural room and then discovered that the elephant was the best thing ever. And there were lots of elephants and there were giraffes and big lions and so I think the world has changed. Well, certainly mine has. And I think there are a lot of people out there that are now super confident. And Effie was the perfect way to illustrate a young girl like so many Greeks. On paper, Effie would appear as failed, I would imagine, her English isn't great. She's working class. She's primarily uneducated, she left at Year 10, went and studied hairdressing.  Walks into any room, whether it's with the prime minister in the room, which I've done a lot of, that high-end corporate stuff. Any room, any place feels worthy, feels relevant and still 35 years in, is that example of someone that is because of self love. It's funny because my current stage show is called Upyourselfness, and Effie, in that, says it's the only immunity we have left is to love who we are. And in the show prior to this one, this one is about political correctness and language. And as I said, Effie's never been great with language, but she's been great with feelings and demystifying things. The show before this one, Effie talked about lockdowns and COVID and she admitted to her own mental health issues. So I think she's a great mouthpiece for me to express so much of what I want to say about the world. She comes in a very animated form and I think people believe everything she says because it is based in truth, my truth. And then I wrap it up in her little boofy exterior and accent and put it out into the world. And so she was born out of necessity and out of my truth.  But yeah, I'm a very hyper sort of person, never been diagnosed with anything other than plenty of energy. And if I look at my mother who's 85, she's got plenty of it too. So I've used energy, and we were talking about this before we started, about how it's important to put the right words with things and then sometimes you can conveniently put a different word that makes it sound better or worse. Some people would look at, say, adrenaline and think that it was adrenaline rather than anxiety because it is a rush and it is something that you can put a positive spin on. I've seen a lot of people that have built great lives and careers out of using adrenaline, and then manifests later as an anxiety. So I am no expert in this. I know what I've gone through.  James Valentine: That's why we've got Charlotte. It's okay. Good. You know what you've gone through.  Mary Coustas: Yeah. And I believe that if you're a human being, you're going to have mental health issues. We're feelers.  James Valentine: Is that true, Charlotte? Is that an accurate observation? We're human beings, so we're going to at some point deal with, it could be anxiety, depression, whatever the label, we're going to deal with something.  Dr Charlotte Keating: Yeah, I think it really is. It's incredibly common, one in six people across their lifespan will experience some sort of mental health challenge, be it depression or anxiety. So I think most of us have either experienced it or have known someone who will, or has.  Mary Coustas: I suppose when I say it, I mean like we're all going to experience grief. We're all going to experience sadness. I mean, not the greatest hits of what we know mental health to be these days, which is a handful of really intense feelings. But I'm just talking about being human. Talking to somebody who's going through something very difficult that you love, or seeing a stranger you don't know on the street that evokes the empathy and all those beautiful things that reminds us of how human we are. We can't have all those feelings without suffering through plenty of them, whether they're directly ours or not. James Valentine: Is it, Charlotte, what that Mary is describing is the anxiety, the depression, those kind of things, those mental health issues – is it when those feelings are too much or become extreme? Or is anxiety, depression, something else?  Dr Charlotte Keating: Yeah, I think it's a really important distinction, James. I think for people who are experiencing depression or anxiety, sometimes those can be emotions that go with everyday life. I think certainly for older Australians, who perhaps have had less opportunity or exposure to the sorts of knowledge, awareness and information that younger Australians have today. They can often, I was thinking about what you were saying earlier in terms of your journey, they can go to the GP and perhaps present with, I have a lot of adrenaline, or I'm feeling quite tired, and not necessarily link those sorts of symptoms to perhaps there is something going on, physical or mental, that could represent perhaps more than just feeling off. I think sometimes we might feel off for a couple of weeks and we might just put it to the back of our mind and keep going. And it can be after really having let it go for some time, that in fact if you do have a chat to your GP or you do have a look, you're like, actually I've been feeling not quite myself for more than two weeks. It could in fact be months, maybe even years.  And whether it's low energy, low motivation, lack of enjoyment or pleasure in the things that might have typically brought it, perhaps even difficulty doing the things you have to do, even things like self care, memory, attention, all of those sorts of things we go, oh, that's probably because I'm tired or or what have you. They can be signposts that there is something going on that possibly you could get some help and support.  James Valentine: But I suppose for a lot of older Australians, it's also the thing to do with those things was to put it to the back of the mind, was to just go on, was to not sort of, what's all this stuff about, mental health? We didn't do that. We just got on with it, Charlotte, you know, it's all very well for you and your fancy diagnosis. We just got on with things.  Dr Charlotte Keating: It's absolutely true, James. And I was having a little look at some of the statistics on help-seeking, for Australians. And certainly for younger Australians, just for a point of comparison, 14% of 35 to 44-year-olds will seek help for their mental health concerns. Whereas 6.8% of 65 to 74-year-olds will seek help. I was actually heartened that there was a percentage of people who would.  James Valentine: Doesn't sound like many though, does it?  Dr Charlotte Keating: It doesn't.  James Valentine: In either group, really?  Dr Charlotte Keating: In either group, exactly. When you can consider the impact it can have on daily life and functioning. But 95% of older Australians see their GP and the GP is the first port of call often for being able to help with these experiences.  James Valentine: I was really struck by what you said, Mary, when you said women are used to experiencing discomfort. And so, therefore, perhaps tend to just roll it into, aagh, it's another one of those things that happens to me. They're not recognised, necessarily, that it could be a mental health issue.  Mary Coustas: It's funny what Charlotte said. I know a lot of older people that I'm close to that go to their GP to probably deal with more mental issues than physical ones. I mean, they're there way too regularly and if you have a good GP that is a good listener and loves what they do and loves their patients, you go there and I think they were stoic. They had to be. These conversations weren't being had then.  And I've been inspired by that generation so much for so many reasons. Sometimes you just have to force yourself to get on your feet and keep moving. I've experienced that personally on occasions, where just too many things happened at the same time that were too heartbreaking for me to be able to pretend it didn't. There was no hiding from heartbreak and grief and trauma and all those things, but I just think that a lot of people are terribly lonely and I think a lifetime can yield a lot of upset and grief and loss. Potential loss of physical capacity, loss of people you've loved, loss of opportunity, loss of all of those things. James Valentine: I wonder, Charlotte, if we're on two different streams here. The difficulties of life are one thing, and the extreme difficulties that Mary's describing there that so many have dealt with, that she's dealt with herself, will bring rise to moments of tension, of pain, of anguish. This is different from mental health?  Dr Charlotte Keating: Oh, it's a really good question. I think what we're really deciphering here is how do we respond to what life involves, what the journey involves. I think it's probably fair to say by the time people have lived multiple decades on the planet there is a sense of stressful life events and experiences that they've all, that they've all had. Some are certainly worse than others.  There can be a compounding effect to some of those. When we think about war or we think about growing up in other countries and things like that, there's all sorts of cultural differences as well with how we process those experiences and in fact, grief and loss as well. And I think that can also lead to questions we ask ourselves about what is normal, with respect to how we process grief, how are we supposed to do it, when is it that it might be important to perhaps seek some support in that way. You've described some stories, certainly Mary, where I'd be interested in understanding more about your experience of grief. I think for many people, perhaps it can be understood in the context of stages of grief. Kübler-Ross is someone that people are quite familiar with in the five stages of grief, being denial or shock, anger, then a sense of bargaining, what could I have done differently, and those sorts of things, with depression and sadness toward the end, and then some level of acceptance of what the loss might be at the end. And those stages aren't necessarily sequential.  James Valentine: Yeah. Or even in that order.  Dr Charlotte Keating: Or even in that order, and I think that there isn't necessarily a timeline, everybody's lives are so different. Their experience is so unique, together with their own sort of personality constructs and uniquenesses. And so, I think if you are listening and you're in a process of grief yourself and you're wondering if you might be a little bit stuck in some of that processing and as you said, Mary, it can be because sometimes there hasn't been a culture of being able to express emotionally or talk about experiences. So you might try and busy yourself or distract yourself or find ways to try and push it aside.  But it does come out, we are biological and physical beings, it's important to be able to express it. And so I would recommend if there is grief you're going through, that's really persistent, very painful and difficult, you're finding it hard not to excessively avoid, or perhaps overthink the challenge at hand, it's really impacting your capacity to get on with your day-to-day, I'd recommend having a chat with your GP about it, or if a loved one you can see is experiencing that, try and talk with them about it.   James Valentine: I suppose we don't have to think of it in terms of when we go to seek help, GP, psychologist, psychiatrist, whatever it might be, we don't have to see it in terms of there must be something wrong with me. Dr Charlotte Keating: That's it.  James Valentine: That I've got a mental health disease. You know, we can go and talk for all sorts of reasons, and maybe I only need to go for half a dozen times. Dr Charlotte Keating: Absolutely. James Valentine: Maybe it's only a short period of time where you need to just be able to talk to somebody neutral, somebody who's not in the family, someone who's outside of the situation. Mary Coustas: Yeah, look, there's a very healthy love of self when you allow yourself to express your journey and your feelings and it's not this taboo thing that we need to dismantle that instantly.  James Valentine: Have you sought help?  Mary Coustas: Yeah, I have. My dad's death was a massive loss, but that was not a tragedy. And then I had a grandmother who I was lucky enough to fly to Greece, my mother's mother, and my mum and I flew there and we were with her when she was dying and that was an honour. And that was the perfect death. You know, she was 93. That was all brilliant.  But I lost a child. And that's a very different loss. And I was given a superstar grief counsellor who is probably one of the most impressive humans I've ever met. Has done better work than I don't know what else. I mean, a brain surgeon would do it with a knife. She does it with openness and no judgment. And she navigated me through what was territory I never dared to imagine, and even beyond that. When I was then pregnant with my now daughter, I was worried that that would rob me of the joy I was finally faced with. And so I had to go and see someone. But someone alerted me to that. My obstetrician, Vijay Roach, super duper star, he's the one that got me Deb de Wilde, who was my grief counsellor. He said, I think you need to go and talk to somebody because he knew my concerns. I'd worked so hard to finally get what I wanted and I didn't want to be in denial of what I'd experienced prior to that. That had happened, but I wanted to put it somewhere healthy and I went and saw somebody and they said, look, there's two ways you can deal with this, you can tell yourself that it's a fear fantasy and you've concocted it, but that doesn't work for you, that wasn't a fear fantasy, that was a reality you survived. So let's take that one off the table, and let's just accept that you have these feelings, these feelings will come and go, and you let them pass through you.  And I did the work. She gave me some exercises to do, and I've got to tell you that on the day of my daughter's birth, I went back to the same hospital where my other daughter had died, and I was in, literally, in the same spaces with the same faces. And I did not connect the two until there was a male nurse that got put on. And he'd also lost a child. And he approached me just before I went into the theatre to deliver my daughter. And it came through another human being. And he said I needed to see the happy part of the story. He was wanting to build up his hope for what was ahead for him. So it happened in the most perfect way. James Valentine: That was a good moment because I could almost imagine, oh, why did you choose this moment to come and talk?  Mary Coustas: Oh no, it was a great moment. And then we had a bit of a cry and I went in and then I was so present to what was about to happen and then when I was being wheeled out holding onto my daughter, high as a kite, I looked at him and we smiled. It was just beautiful. It was like something in the movies, you know. James Valentine: Yeah. Charlotte, as people age, unfortunately, these kind of moments will happen, a child can die. Not necessarily in birth, but your 20-year-old, your 25-year-old. You're 60, 70, 80, your child can die. Your partner can die. Your friends start to die.  You yourself will start to face things that are going to be extremely difficult. And again, I wonder whether we conflate these things into, you'll only go and talk to a psychologist or counsellor of some sort, the priest when it's really extreme, or if you've actually got some sort of mental health issues.  Again, this is not the case, is it?  Dr Charlotte Keating: Yeah, I think it's shifting a little bit, James, but I think it has long been that challenge of, oh, unless I'm really at breaking point, then that's for somebody else who really needs it. That's not for me.  James Valentine: I had to have had a nervous breakdown. Dr Charlotte Keating: Yeah, I think that's exactly right. And I think that as you just both described, life is full of challenges and losses at various different stages, whether it's when you're trying to start a family or, as you get older, family members might have challenges or problems going on themselves. It could even be in the context, there were things we don't ordinarily think about, say retirement, and moving towards something that you've derived a great deal of sense of self worth, purpose, meaning.  There's a change in one's sense of self or identity that can surround that and even things like irritability and anxiety can be linked to those but people don't necessarily know. Sometimes they do, but they don't always necessarily know and sometimes it'd be so valuable, as you said before, Mary, having a conversation with someone who really can change the trajectory of subsequent experiences you have, not even just the one that you might be seeking some sort of counsel for. Mary Coustas: Yeah. And I also think with these conversations, the people that will help you get on the road to alleviating some of the discomfort of being human are not often the doctor. Someone else will tell you about it, you will have a conversation, this is where it's important we stay close and we keep talking to each other. And I don't want this to be simply about what is difficult because there are so many great joys. And if you can get to those highs, you're going to get to those lows, you know? But friends or someone like in my case where people have said I had an issue, with something like that, you should talk to. And it just makes it feel much more natural and less taboo-ish if it's coming from someone who's done it themselves.  And we need to keep reminding ourselves. That's why campaigns like R U OK? Day and all of those beautiful things that people have put out there, just to remind ourselves that some days are going to be better than others. And there are memories and triggers everywhere for us, especially if you've gone through difficult things that can evoke those feelings to come back up to the surface. And we know that community is a huge part of what makes people happy in that whether you're watching the Blue Zones documentary series or listening to people from The Happiness Institute or wherever you go to find your insights into what is healthy and what breeds longevity.  And it is community. And it is a priest, in those days, or an older family friend that perhaps isn't directly in your family, or someone you can go to and talk to about the things that are weighing you down. And I think that even podcasts like this are so useful to just say… You can't afford to ignore those things that are very difficult to get through. We're not supposed to get through this stuff alone.  James Valentine: Yeah.  Mary Coustas: We're born in communities and surrounded by people, and we should take complete advantage of that. James Valentine: And it makes me think that particularly for men, as you say, are perhaps not as accustomed to talking, not as accustomed to having those sort of friendships that women have, that I'm often quite jealous of. It's like, how come you've got these four friends you go and talk to all the time? Men need to cultivate that. Men need to learn to cultivate that, and perhaps particularly in retirement, those work contacts have gone, and you need to learn how to have those conversations that are intimate, that are real, and have that group of friends. You play golf with them, you play tennis with them, it doesn't matter what the initial contact is, but start to change the nature of the conversation at the bar afterwards.  Mary Coustas: But don't you think golf,  the reason why it's taken off so much is two: one, you're competing with yourself, right? And that's the healthiest competition there is, as far as I'm concerned. I always say to my daughter, you're not competing against anyone else, you're competing against yourself.  But also it allows for talking time between moments, and I think that's why particularly so many men are drawn to golf.  James Valentine: Yeah, that's right. But I think this is something, Charlotte, for men to probably deliberately consider, you might need to deliberately think about cultivating that group that's perhaps got a different kind of talk going on. Dr Charlotte Keating: I think that's right, James, and I'm hesitant to say, but I almost want to say, watch what the women around you do, and try and go, okay, well, that's what they talk about, or those are the sorts of things maybe I can do that too. I think as well, there's leaps and bounds being made in places and spaces like the Men's Shed, definitely a place where the capacity to be vulnerable and connect and really talk honestly is created.  And I think if you're going for exercise in the morning, you can often see perhaps the end point of the cycling gang, they're having their coffee and they're actually just talking and chatting a little bit.  James Valentine: But stop talking about bikes, fellas. Come on.  Mary Coustas: Stop avoiding the real issue.  Dr Charlotte Keating: I wouldn't argue with that. But I think it's trying to take the opportunities where they might present and then also thinking about what sorts of hobbies and things do I like doing? Maybe I've played golf once every couple of years or, if I had to, maybe I'll actually pick it up with some determination. Or tennis or cycling or walking or swimming.  Mary Coustas: Or in the case of the Greeks – because I spend a lot of time in Greece, I've got a house there and all my family apart from my mum and my brother are in Greece – the men meet every day and have coffee. Every day.  James Valentine: Do they talk? Do those old men sit there and talk?  Mary Coustas: They talk about everything. James Valentine: Real stuff? Mary Coustas: Real stuff. Greeks, we like to think that our feelings live on the outside of our body. We're very verbal and expressive.  James Valentine: Right, right. If only you could keep some in.   Mary Coustas: Yes, exactly. Do I really need to know that every little detail?  But you see them and my house is around the corner from the oldest cafe in the area and they gather there every morning. And they play backgammon and they chat about what's happening with their kids, and their grandchildren and what they have to do that day, and then they meet up again, either later when it cools down again for the evening, but they're out.  And I think one of the best things that you could do, and I say it to so many people when we're chatting about this, is you've got to be careful of the conversations you're having inside your head. And you've got to get outside of your head and into, all of you, into a physical world, into a social world. Because you can talk yourself into anything. There's no objectivity coming through that non-stop monologue that's happening internally.  And it's good to be able to go somewhere. Whether it's a doctor, whether it's a group of friends, start a new routine, have something to do that gets you up and out every day to, to mix with others, to learn from their stories, to be able to express yours. These are all super healthy things.  Dr Charlotte Keating: So well said.  James Valentine: Mary and Charlotte, what a beautifully rich conversation that was. Thank you so much. Mary, thank you so much for your openness through all of this.  Mary Coustas: My pleasure. That's my favourite thing to talk about, is human beings.  James Valentine: Yeah, but the fact that you've been able to write about your suffering, and express that so publicly, so so well, that's so important too, and I thank you for it.  Mary Coustas: Well that's one level of the therapeutic process is to be able to put it outside of yourself somewhere, whether it's in talking or in writing. I mean, I'm lucky that I'm in a public domain so I can put it out there for others to respond to.  And my whole career has been about dispelling taboos, and talking about the difficult things. And I wrap it in a capsule of comedy and that's what makes people happy. And it's what makes me happy. And that's my antidepressant. It's a very joyful job, but I try to shove in as many issues in that capsule as I can to sort of liberate myself and everyone that's there.  James Valentine: You do it beautifully and joyfully and thank you so much. Charlotte, thank you for sharing your expertise. Great to meet you.  Dr Charlotte Keating: You too, thanks James. James Valentine: Dr Charlotte Keating runs her own private practice on the Lower North Shore in Sydney and Mary is about to embark on a national tour called Upyourselfness. You've been listening to Series 5 of Life's Booming: Is This Normal? Another season will be coming along later this year, so stay tuned wherever you get your podcasts. I'm James Valentine. Thanks for listening.See omnystudio.com/listener for privacy information.

In this episode we spotlight gut health, and all the normal, and more unusual, health issues connected to our digestive systems. We speak to clinical nutritionist and the author of The Gut Repair Plan, Sarah Di Lorenzo, plus Melbourne chef and founder of Made by Tobie, a home delivery meal service, Tobie Puttock. About the episode – brought to you by Australian Seniors.  Join James Valentine as he explores the incredible stories of Aussie characters, from the adventurous to the love-struck. Across 30 inspirational episodes, Life's Booming explores life, health, love, travel, and everything in-between Our bodies surprise us in ways we never thought possible as we age, so in series five of the Life's Booming podcast – Is This Normal? – we're settling in for honest chats with famous guests and noted experts about the ways our bodies behave as they age, discussing the issues and awkward questions you may be too embarrassed to ask yourself. Sarah Di Lorenzo is a clinical nutritionist and author of four books, including her latest, The Gut Repair Plan. She is resident nutritionist for Sunrise and Weekend Sunrise, and is passionate about sharing information about a healthy diet and eating the right foods to help with sleep, stress, weight loss, immunity, and slowing down the ageing process.  Chef Tobie Puttock began his career in Melbourne, before travelling and cooking around the world, including alongside good friend Jamie Oliver, who shared his passion for simply cooked food. His most recent focus is his own brand of frozen ready meals, Made by Tobie, with a focus on producing meals that aren't harmful to us or the environment.   If you have any thoughts or questions and want to share your story to Life's Booming, send us a voice note - lifesbooming@seniors.com.au. Watch Life's Booming on Youtube  Listen to Life's Booming on Apple Podcasts Listen to Life's Booming on Spotify Listen to Life's Booming on Google Podcasts  For more information visit seniors.com.au/podcast  Produced by Medium Rare Content Agency, in conjunction with Ampel Sonic Experience Agency   Transcript: James Valentine: Hello and welcome to Life's Booming Series 5 of this most excellent and award winning podcast. I'm James Valentine and in this series we're going to ask the question, is this normal? I mean, as we age, stuff happens to us. Our bodies change, things fall off, we get crook, stuff doesn't work as well as it used to. There's nothing we can do about it, we're getting older, we're ageing. But which bits are normal? Which bits do we have no control over? Which bits can we do something about? That's the kind of questions that we're going to be asking in this series, Is This Normal? of Life's Booming. Now, of course, if you enjoy this series, leave us a review. Tell all your families and friends about it. And we want to hear from you as well. You can contribute to this. If you've got questions about things in particular that you want to know, perhaps there's some particular wear and tear happening to you, let us know. We'd love to see if we can answer that question in the series. We're going to look at things like menopause, gut health, mental health, lots of other burning questions. So, think about those areas and if there's something in there that's specific to you that you'd like us to cover, let us know. On this episode, Getting to the guts of it, we spotlight gut health, the normal, and the more unusual health issues connected to our digestive systems. We speak to clinical nutritionist and the author of The Gut Repair Plan, Sarah Di Lorenzo, plus Melbourne chef and founder of Made by Tobie, a home delivery meal service, Tobie Puttock. Sarah Di Lorenzo: Hi, thank you so much for having me.  James Valentine: Why are you a nutritionist? I can't even say it! Sarah Di Lorenzo: Nutritionist, a clinical nutritionist. Why? I started with my own gut health, really, was what drove me into becoming a clinical nutritionist. I just did really notice around the age of 15 that foods affected me differently. I noticed it with white bread in particular, and I would go home and say to my dad, who's a psychiatrist, a doctor, and I'd just say, I don't feel well when I eat that food. And he goes, oh yeah, yeah, we all feel like that from bread. It's probably a Greek thing, whatever. You'll be fine. Don't worry. And so I watched my dad always living his life bloated, and I was like, yeah, yeah, it's not great.  And then when I was in Italy when I was 18 for a few months, it was the most incredible experience that I clearly just couldn't enjoy, because I had gut issues, I had non-coeliac gluten insensitivity, self diagnosed. And then I ended up after that, when I came back at that young age, I was doing my science degree at Sydney Uni, I came back and I was like, I need to work on my gut because my quality of life is not great. And so it dominated my life and I just couldn't enjoy my life. And so that's what I started doing was working on my own gut and I'm 51. So that's like 30 years ago, more so 32 years ago, I started, I realised then, so I went through my own gut healing journey and have spent a lot of those younger years just looking at my own rest and retest, trying different foods, creating menus, creating diets, I just did it as a hobby and a passion.  And then I went on to study nutritional medicine after that, when I realised that it was really my calling. I feel like I'm a healer. I do. I've healed myself and now I want to heal everyone else. James Valentine: Now, let's go to chef Tobie. Hello Tobie.  Tobie Puttock: Hello, how are you today?  James Valentine: Thank you so much for joining us. It's fantastic to get some time with you. This is something that's close to you. You think about the gut a lot. Tobie Puttock: My wife, when we first met, she was very controlled by her stomach issues. So obviously all tied in with the gut. She had food poisoning when she was younger so badly she was hospitalised for a few days – not from my cooking! I didn't know her at this stage, it was in the UK, and it really screwed her gut up.  So I remember for the first about three or four years of our relationship, everything was dictated by that. And it was IBS basically. And I didn't really understand, I'd never met anyone with such an issue before. And, you know, we'd have dinner plans, we'd be all ready to go. And suddenly her stomach would start to feel uncomfortable and we'd have to cancel dinner. Our whole life revolved around the stomach issues and after being together a few years, I had the opportunity to write my first cookbook. We were living in the UK at the time, we came back to Australia and I met an amazing person named Dr Sue Shepherd. She goes under a different surname these days, but she is kind of a guru in the gut health space and she spent some time with my wife and basically together we adjusted her diet and she solved her own issues. So she no longer has IBS. James Valentine: That's great. And it's come on a lot, hasn't it? Our consciousness of the gut, eating for our gut biome, I would say it's a way of thinking about food that's come up about in the last decade or so. Tobie Puttock: Yeah, 100 per cent. Being in food for my career and my whole life revolves around food, I see things jumping in and out of fashion and gut health has been a huge fashionable topic for a long time, and now it seems to have mellowed out into actual just fact. People accept that your gut is super important and eating the right foods and gut health really can make a huge difference to your life. James Valentine: Yep. Well, let's plan a diet, a pantry for good gut health. What kind of dishes, what kind of ingredients do you focus on if you're thinking gut health?  Tobie Puttock: Well, first of all, I try and eat as little processed foods as possible. So I also have quite an empty pantry at most times, but obviously fermented foods are fantastic, I do a lot of fermenting. After I jump off here, I will be going to make sauerkraut this morning, but things like kimchi, most fermented foods, are fantastic. And then there's going to be, if you do have things like IBS, there's going to be a lot of trigger foods that will be quite acidic as well. But yeah, definitely for me, we have a lot of sort of robust greens, lots of cavolo nero, Tuscan kale, brussels sprouts and all the good stuff there. James Valentine: Right. I like that description of robust greens. These are the tough ones.  Tobie Puttock: All the brassicas. So we're steering, you know, I think things like cos lettuce are fantastic and they're sexy and rocket lettuce and all that kind of stuff. But I remember a few years ago, it was probably 2013, I made a big life change, I just got spat out of kitchens, I was probably quite unhealthy without realising it, I was just going through life as a lot of people did and I was insanely stressed. And I started doing a lot of yoga, and my wife, at the time, was seeing a personal trainer and trying to get shredded. And she was going to the personal trainer a couple of times a week, but coming home to eating my Italian food that I cook in restaurants, which I now wasn't cooking because I wasn't in restaurants. And she gave me a list, this amazing list of all the things we can have as much as we want of, things we should never have, and things we can have in moderation. And we started cooking from that list. And I should also pop in there that we tried to conceive and it didn't happen naturally. And they tried to tell us – well, they did tell us – that IVF would be the only way. And with a total diet overhaul cutting out all processed foods. And I don't want to say that kale saved our life or anything, but it kind of gave, you know, kind of did a little bit. I lost probably six kilos of body fat, my wife lost 10, and she wasn't big to begin with. We conceived naturally, and we kind of look at those as some of the fondest years of our life. And then we had a kid and started eating junk food, and did the reverse of that because we were young parents – or new parents, I should say. Yeah.  James Valentine: Yeah. All hail kale, I say. So Sarah, what happens to our gut as we age? What are the sort of things we need to be aware of as we're 50, 60, 70? What's happening? Sarah Di Lorenzo: A lot's happening. I mean, I kind of noticed this when I thought, even myself, like it ages. It's as simple as our gut does age. We don't produce as much saliva as we used to. But if you think about eating, say a highly processed meal when you were young and be like, oh that was okay. Or even getting blind drunk when you were young. And then you think, well, that was okay. You go and now in your 50s, you go and eat a big processed meal and you're like, oh gosh, you kind of really do feel it. Or you go out and have a big night on the drink. The next day people will notice it.  James Valentine: The next two days.  Sarah Di Lorenzo: People notice it. They really feel it. So look, it ages. At the end of the day, when you really look at it, first of all, we don't, as I mentioned, there's just not as much saliva. People don't produce as much of the digestive enzymes, so like lactase, so people notice things like, oh I'll hear things in clinic, I just don't really seem to process dairy like I did when I was young. Well, cause you're not producing enough digestive enzymes, so it comes that whole process ages as well, and there's just, even the way our peristalsis, the whole system is… James Valentine: Is that swallowing? Sarah Di Lorenzo: Yes, swallowing issues, chewing. People tend to change their diet as they're older. If they've got things like dentures or dental issues, it can start right from there. So, the microbiome changes. The microbiome is the habitat which our microbiota live in. So I always explain that to people.  James Valentine: This is all the bacteria in our gut.  Sarah Di Lorenzo: Bacteria, fungi, viruses.  James Valentine: This is the new thing. This is the newer discovery. This is not stuff we understood. You know, when you were first going, I don't feel so good.  Sarah Di Lorenzo: Correct. Yeah, this is all new stuff and it is fabulous. When I was actually reading all this stuff and I was putting this book together, I'm just in awe of our gut. Like, I'm so impressed by it. I really am. The residents that live there, that I might point out, our gut bacteria, weigh two kilos. Yeah. Yeah.  James Valentine: Isn't that amazing? Two kilos of biomass of living stuff.  Sarah Di Lorenzo: I find that fascinating.  James Valentine: So like, do they change if we don't look after them?  Sarah Di Lorenzo: Correct.  James Valentine: Or do we need to do stuff? Are we trying to keep a youthful gut or do we need to understand our maturing gut? Sarah Di Lorenzo: Well, there is that, but look, we do need to take care of it. And this is one thing that I see as people age what they don't do is they don't create that diversity. So our gut bacteria love, love, love a diversity in our diet. So as we age, we tend to eat the same things every day. People have the same breakfast every day, the same lunch, the same dinner. They don't eat a lot.  Now, it's actually, and that's one of the biggest problems. So as you age, it's really important to make sure that you've got that diversity to feed that good bacteria in our gut. We want those colonies broad. We want to feed, because all the different bacteria do different things. Like we've got a bacteria, which is my favourite one, called akkermansia muciniphila. James Valentine: But that's easy for you to say. Say that again. It's a what?  Sarah Di Lorenzo: Akkermansia. It's my favourite bacteria. I love this bacteria. We want lots of it, so akkermansia muciniphila is one that keeps us at a healthy weight. And then you've got like bifidobacterium, which actually helps break down the food we eat. I know you're looking at, if anyone could see James right now! James Valentine: No, it's impressive. Okay, very, very good. It's like when people see birds and they use the Latin name. It's like, very good. Well done.  Sarah Di Lorenzo: Now I've lost my train of thought. Yeah, sorry. Okay, as we age… James Valentine: Yeah, as we age. I think what I'm interested in is, like, with a lot of things we want to stay, we need to stay, youthful. Is our gut like that, or should we be allowing our gut to mature? Sarah Di Lorenzo: I would want to be keeping my gut as young as possible. Definitely. The other thing we forget is medications that people take as they age. So medications can really impact gut health. And we know that. People often take laxatives when they're older. There is actually this recent study that came out that showed that people who use laxatives – not stool-bulking laxatives, but actual laxatives – have a 51% increase in their risk of dementia, which shows that gut brain axis. So there's a lot of things that can, stress is a really big one. It can be stress with ageing, stress for whatever, that will impact gut health. But it is creating that diversity and we only eat I think, 75% of the adult population only eat from 12 different plant types over the course of the week. That's some research that I have seen. So one great thing that you can do to start to improve and feed all those different colonies down there, like akkermansia, and grow more of them, the one thing you can do is make sure, a little test you can do, is make sure you're eating 30 different plant species over the course of the week. James Valentine: And Tobie, how do you approach getting that diversity in the diet?  Tobie Puttock: Yeah, there's a lot to be said for it. General nutrition, I have a basic understanding of, but my main thing is making things taste good. Which is what I wanted to do with my book, The Chef Gets Healthy, which was about making everyday food. Because I think as a society, we tend to look for easy answers for big problems.  And I remember at one stage, the fried southern chicken burgers were trendy. And then on the other end of the scale, you had Pete Evans pushing these really super hardcore diets like the paleo diets. And I always think that the answers lie somewhere in the middle. You don't need to go to these extremes. James Valentine:  Okay. Well, give us some insights into what you do with these sort of things. Cause I think sometimes people say, look, the fermented foods, kimchi, sauerkraut, they're good. And then you should be eating more of the brassicas, the broccoli and the sprouts and all that sort of stuff. But if you're used to the steak and veg, if you're used to the pizza, you don't know what to do with this stuff. Tobie Puttock:  Yeah, it's true. And I believe that you can still eat all that. You just need to add in vegetables. So I think as a society we're getting better at this, but until recently we've eaten way too much protein. Aussies tend to eat beef or lamb, or similar sort, four to five nights a week and even more seven nights a week. I remember speaking to somebody saying, oh, you should have fish once or twice a week. And they had no idea. They never cooked fish. They had no idea of the health benefits of that as well. But my belief is that we need to pull back on eating meat, substantially, for so many reasons, you know starting with environmental, but also our health as well. So I believe a great diet and a lot of research has been done on this and proven, the Lancet report has shone some great light on this, which is that we should probably eat a vegetarian diet three to four nights a week. Eating meat is expensive, so you can save that money that you're not spending by cutting meat out of the diet three to four nights a week. And then when you do eat meat, eat a fantastic cut of meat that's sort of grass fed, comes from a reputable supplier, therefore we're not fuelling the inhumane farming trade. And you will notice huge differences. Now, simple ways to cook vegetables. I've worked in very technical kitchens and it's funny, because since I've been out of kitchens since 2012, I've often realised that cooking vegetables, the easiest way, is often the most flavoursome and nutrient-beneficent.  So, I grew up with a British father who grew up in a family which was often, I think, frozen vegetables, or vegetables that were cooked until all the chlorophylls and colours had gone out and they were grey. I do the polar opposite of that.  So, I'm not into a raw diet, but I think you need to cook vegetables until, for example, with kale. Let me talk you through one of my favourite quick dishes. So we do a breakfast, which is, baked eggs and kale, and fantastic. And my meat-eating friends who I've given this to just go bananas for it.  So it starts in a pan with a little bit of olive oil, and garlic and chili – so aglio e olio base – and you sauté that off over a low-to-medium heat until the garlic starts to soften and become translucent, at which stage you break in some kale – and cavolo nero, which is a type of Tuscan kale, is also fantastic. Even more robust leaves than the traditional green kale that we're familiar with now, with those stems which are really fibrous. I normally leave those out and keep them for a juice or similar, but they've got a lot going on, our body needs them, but for this particular dish, not the best. So break off the leaves, sauté them around, mix them through with the oil and the garlic and the chili until it just starts to green, at which stage you can crack a couple of eggs into there. And then normally over the top of that, I break some feta cheese into there, dabble a little bit of natural Greek yogurt, some hemp seeds, a little good pinch of sea salt and pepper, bung the whole thing into the oven just until the eggs are set. We're talking two, three minutes.  So you can make this whole dish, if you're good, in under 10 minutes. And it's got a lot going on there. You're going to get all that beautiful fibrous veg from the kale in there. And the protein from the eggs, the hemp seeds are fantastic, and the whole thing just tastes amazing. It's a delicious breakfast. But kale can be really, really easy to cook. I mean, it's as simple as sautéing it down for a couple of minutes.  James Valentine: So Sarah, tell us more about feeding our gut bacteria.  Sarah Di Lorenzo: So we want to feed these guys with prebiotics. So that's what they eat. Bacteria need these prebiotic-rich foods, which are the foods people just don't get enough of.  They might go and take probiotic supplements, but you need the pre's to feed the pro's. It's as simple as that. Prebiotic-rich foods, fibre, that we can't digest as humans, but the bacteria feast on them. And so we want all of those wonderful foods. Now things like asparagus, apples are great, onions, garlic, oats, and all great foods, sourdough is another good one. All excellent foods that we should really be eating. Leek, Jerusalem artichoke, they're all coming to my mind now. You can see my mind is flowing in with them. I've unlocked that part of my brain, which is full of prebiotic information and let it flow out. Yeah. So we need to actually feed them to grow. And in turn, their waste product, the bacteria waste, is what we as humans thrive on, it's critical for our overall health and wellness. And we call their waste, which is called a postbiotic, is actually a short-chain fatty acid, or it's called butyrate. So butyrate feeds our colon cells. It makes the wall of our gut strong and firm, which is what we want. We don't want it inflamed and leaky, where you get what's called leaky gut syndrome that leads into migraines and headaches. And so that's called post. I'm obsessed with butyrate. I just want so much butyrate. I would drink it. So you can see that's how it all kind of works.  James Valentine: Yeah. Yeah. And so we should be getting all this through foods, not through supplements, pills, little liquids, you know, things that are meant to sort of put it there. Just do it through the stuff that you eat? Sarah Di Lorenzo: Correct. But if you were, for example, someone who was taking a course of antibiotics, because the antibiotics, whilst they're amazing and they save lives and they wipe out the bad, they also wipe out the good. So if I was to have to go on a course about antibiotics, I would take probiotics, I would take them in supplement form, but I would also make sure I was feeding that, just having a bowl of oats for breakfast or having some asparagus, asparagus is a good one, or just throwing a lot of onion and garlic in my food, making up shots of different… just adding it in where you can. James Valentine: This is so much when we start to hear, the Mediterranean diet, that it covers all of these things, doesn't it? You cook with onion and garlic, there's oil on stuff. You will have sort of an oats or, you know, muesli type thing for breakfast or a cookie that's like that. This is the stuff.  Sarah Di Lorenzo: Correct. And also all the legumes you forget that are so high in fibre. I think Westerners just forget about legumes. And they are…  James Valentine: This is your chickpea, your beans, all that sort of stuff.  Sarah Di Lorenzo: Yes. Lentils and chickpeas and beans, and they dominate the Mediterranean diet and people shy away from them because when they eat them – and this is the whole problem with fibre. We don't eat enough fibre. That is a huge problem. Part of the ageing process is people just don't eat enough fibre. Because when you introduce fibre to people that aren't used to it, they get flatulent and distended. And they go, oh I've got FODMAPs or I've got this. And I'm like, no, no, no. You just had too much fibre, too quickly. You have to introduce fibre slowly to people to get them over it. That's what I've written. The four-week plan of my book is just that slow introduction of fibre so people don't get those symptoms.  But it is a common base of the Mediterranean diet and the gut bacteria, it's all about feeding these guys, making them happy, making them grow, making all the good ones grow. And in turn, supporting our health. It's pretty simple, but when you do the deep dive into it and look at all the different types of bacteria and as you can see, there's bacteria for mental health, bacteria for weight, bacteria for skin, bacteria for heart. And so we want lots of them, not just feeding one, which is why you can see that diversity is really important. James Valentine: So I suppose I'm thinking that we had a long period of time where we worried about the heart. You know, there was a lot of focus on the heart. The heart's the thing. You have to deal with that. And then we've had a period of time where, look, it's weight. Weight is most important. You know, you've got to keep the weight off and make sure that you're at the right weight and that sort of stuff. Is the gut just sort of the trend? Is it just the sort of the thing that everyone's talking about now? Because we're bored of talking about the heart or something like that. Is there more to it than that?  Sarah Di Lorenzo: I think that when you think about trends and fashions in health, like, okay, well, cardiovascular disease, clearly it's a leading cause of death and disability. So it's always going to be there. I do feel there are trends. I think trends are what you've got to be really careful of. Like at the end of the day, the heart's the centre, I mean, you have to take care of your heart health, and it still is that, it is the leading cause. And then weight is something that I feel it's evergreen. Look, at the end of the day, excess weight is inflammation, inflammation drives disease, it's just as simple as that. Any patient that comes into my clinic, and sits down, and, oh hi Sarah, look, I'm here for my menopause, my gut, my cardiovascular, and I've seen them 15 to 20 [times], and I will say to them, okay, I'm not going to sit here as your practitioner, and just do a treatment protocol for your cardiovascular condition.  Because you're carrying 15 kilos of weight.  So it all ties in together, so every single patient that sees me has to get to a healthy weight, because I know that it's so inflammatory. Adipose tissue is like this. It's big, it's proinflammatory cytokines, it is inflammation. Inflammation drives disease. And number-one of the diseases is depression. Before you start going to cardiovascular, diabetes, thyroid, arthritis, or before you even go down that path, metabolic syndrome, it is the driver. And as far as gut goes, people who are overweight have poor gut health. I'll tell you an exception to that though. So people who are overweight, talk to them about getting to a healthy weight and working on increasing that. The only exception would be, when I think, cause I'm right now, I'm just scanning all my patients that are currently in my clinic while I'm talking to you, is someone who would come in with H pylori [helicobacter pylori], and undiagnosed. So I had a lady who brought her husband in. And this is quite a funny story. They're both 45, great couple, no kids, living their best lives. They don't want kids because they're fabulous and they want to just travel and enjoy. She can't cope with the amount of times he farts in a day. So she's just like, he farts way too much. James Valentine: How many would be too much?  Sarah Di Lorenzo: Well, I'm going to ask, I'm going to do a pop quiz on you James. Okay. How many farts do you think we should be doing a day as humans?  James Valentine: I would go for around the dozen.  Sarah Di Lorenzo: Not bad. Okay, 15 to 22, so yeah, you weren't far off. This guy was just farting all day. So I asked her that and she said it's constant. Like it's probably every five minutes. And she said it's actually ruining our marriage. I said, yeah, fair enough. And she can't sleep in the same room as this poor guy. So healthy weight, fit guy, Lebanese, so ate a lot of raw meat. I knew that there was something going on. I knew he had a parasite of some kind. So I just sent him off for a test, came back, he had helicobacter pylori. And so we cleared up the H pylori, their marriage is back on track.  James Valentine: And he's back to the 15 or 20 that we should all be doing… Sarah Di Lorenzo: …instead of doing about a thousand. So that would be the exception. And what I do see is people that come back in from travelling to places like Indonesia, who come back and they've had Bali Belly or different things, so they're the ones I also see, which again, where a parasite has impacted their gut, and it does ruin people's lives.   James Valentine: Let's say I'm 70, I've never done any of this. Can I change? Is my gut going to change? Is it all too late?  Sarah Di Lorenzo: It's never too late. I don't care, like actually, I had someone write to me this morning, because I did a post about how much I hate artificial sweeteners, and they said, is it too late? I've had my whole life living on Equal, and I drink Diet Coke every day, and I've got diabetes. No, it's never too late. I will always say, I will never give up. I will fight for someone's health to the end.  James Valentine: Tobie, for general gut health, if you're doing as you describe, you have two, three, four vegetable-based dishes a week, you're more conscious of eating some raw greens and that sort of stuff, you can have a pizza on Friday night? Yeah, you can have a glass of wine. It's not to say you've got to get rid of these things? Tobie Puttock: No, it's about balance for me. It's like, I still have Cadbury chocolate in the fridge. I love that stuff, but it's about the majority of the time eating as well as you can. And of course we know we sort of started to get into the realm of biohacking now. And we've got all these tech billionaires who will look you dead in the eye saying they're going to live to 150. And we've got, I forget the gentleman's name. He's reversing his age. He's a tech billionaire in Silicon Valley and he's now got the innards of about a 30-year-old and he's about 45 and he's going back about three years for every year. So there's a lot to be said for that. Now we know that through processed diets, this shortens your life,100%. And we don't even have all the data yet, but a lot of the processed foods and I get really worried about these younger generations who can't cook, they're all into the cooking shows and they love watching it as eye candy, but they can't cook, which for me is such a basic life skill. But if you look at all the oldest living people in the world without gut issues and all these kinds of things, they're eating very natural foods. They're in, you know, the Mediterranean, they're in Japan and they're eating just a lot of good produce.  James Valentine: Yeah. Now, coming back to you, Sarah, what are your thoughts on this? Sarah Di Lorenzo: So when I do gut repair work with people, the thing is, you get these people in, and I'll say, OK, so give me what are you eating today? I don't really know, I kind of, oh so you wing it, you ad lib the day. OK, so when I have an ad libber or someone who wings the day, all right, give me a 24-hour recall. So that's my next question. Oh, yesterday, oh, I had a couple of pieces of toast. Ah, a bit of jam, I don't know, I just had that on the fly, grabbed a coffee. Had some Arrowroots at work or at home with the wife watching, you know, more breakfast television. Oh, I don't know what we had. Oh, we had leftovers for lunch, that's right. Oh, my mum cooked, my wife cooked a spaghetti bolognese for the grandkids that came over in the afternoon. Oh, we had some bikkies or whatever. A bit of chocolate. They don't really know. And it's a lot of highly refined processed food, which is really dry, which really increases the production of insulin, which is driving disease, etc. So when I say to them, right, do my gut repair plan for four weeks, I am taking them from what they think is okay as a Western diet. They might even be having a white bread sandwich for lunch or a stir fry for dinner. To me, that's a Western diet. So when you take someone from that and you say, right, do all your food prep, get everything organised, start your program. And you put them on my program, which is a gluten-free program – number-one common allergen – first thing to go is headaches. And then you get that clarity of the thought instantly within three days you'll feel better. Energy, body systems working well, better sleep, better mood. And within three days, I'll get messages. I see her on my day three of the gut repair. I've gone to the toilet twice today, three times today, I had a really good night's sleep. I feel my energy's really up in three days. So you can see, as I mentioned in the beginning of our chat, eating rubbish food and going out and hammering yourself on the booze, you get that input, like you picked two days. So you think two days of healthy eating.  The gut does respond. So it will respond very quickly within three days. But to really overhaul it, I would say minimum three months. But it has to be lifelong.   James Valentine: Yeah. What a great conversation. We've been into the stool. We've farted a bit together. We have. We've got the boy working. Yeah. I love it. We've covered so much good ground. And yet all of it is in an area that we've really only just started to think about. We should be thinking about all the time. It's sort of one of the most simple things we can do, isn't it? Sarah Di Lorenzo: It's so basic.  James Valentine: It's really just, eat a lot of plants… Sarah Di Lorenzo: …eat well, avoid processed food,  James Valentine: …the stuff that comes in a package and it's processed, it's going to be bad for you.  Sarah Di Lorenzo: Reassess your health, stay on top of it, diversity, plants, hydration, exercise, sleep well, stress management tools are really important for the gut brain axis, for the stress, taking care of your nervous system. It's never too late. It's never too late.  James Valentine: It's never too late. Get on with it. Happy gut, happy life.  Sarah Di Lorenzo: Absolutely. That's it. That's the foundation for everything.  James Valentine: Thank you to Sarah and Tobie for your delectable advice. You've satisfied our hunger for knowledge of a healthier gut. You've been listening to Life's Booming, brought to you by Australian Seniors.See omnystudio.com/listener for privacy information.

Embarrassed about asking your doctor something? We're doing it for you. Our experts are going to answer some of those concerns you might have that are a bit quirky, less dinner chat, more private google search type questions. Our expert doctors are getting the stigma out of the way and getting you on your way to a healthier life.  About the episode – brought to you by Australian Seniors.  Join James Valentine as he explores the incredible stories of Aussie characters, from the adventurous to the love-struck. Across 30 inspirational episodes, Life's Booming explores life, health, love, travel, and everything in-between Our bodies surprise us in ways we never thought possible as we age, so in series five of the Life's Booming podcast – Is This Normal? – we're settling in for honest chats with famous guests and noted experts about the ways our bodies behave as they age, discussing the issues and awkward questions you may be too embarrassed to ask yourself. This episode, we hear from Sydney GP Dr Sam Hay. Also known as Dr Kiis, Sam is director of the Your Doctors network, health expert for Kidspot, and was host of Embarrassing Bodies Down Under and Amazing Medical Stories. You'll also hear from geriatrician Dr Simon Grof, who has been a consultant geriatrician at Victoria's Eastern Health since 2014, and is Chief Medical Officer at Jewish Care Victoria, who talks through some questions of ageing in later life. And Dr Mohammad Jomaa is a Sport and Exercise Physician, who has a special interest in sports-related injuries and their management, and shares his advice on mobility and healthy exercise for over 50s, to maintain longevity.   If you have any thoughts or questions and want to share your story to Life's Booming, send us a voice note - lifesbooming@seniors.com.au. Watch Life's Booming on Youtube Listen to Life's Booming on Apple Podcasts Listen to Life's Booming on Spotify Listen to Life's Booming on Google Podcasts For more information visit seniors.com.au/podcast. Produced by Medium Rare Content Agency, in conjunction with Ampel Sonic Experience Agency   Transcript: James Valentine: Hello and welcome to Life's Booming, series five of this most excellent and award winning podcast. I'm James Valentine and in this series we're going to ask the question, is this normal? I mean, as we age, stuff happens to us. Our bodies change, things fall off, we get crook, stuff doesn't work as well as it used to. There's nothing we can do about it, we're getting older, we're ageing. But which bits are normal? Which bits do we have no control over? Which bits can we do something about? That's the kind of questions that we're going to be asking in this series, Is This Normal? of Life's Booming. Now, of course, if you enjoy this series, leave us a review. Tell all your families and friends about it.  And we want to hear from you as well. You can contribute to this. If you've got questions about things in particular that you want to know, perhaps there's some particular wear and tear happening to you, let us know. We'd love to see if we can answer that question in the series. We're going to look at things like menopause, gut health, mental health, lots of other burning questions. So think about those areas and if there's something in there that's specific to you that you'd like us to cover, let us know. On this episode of Life's Booming, we're tackling your frequently asked questions. Embarrassed about asking your doctor something? Today, we're going to do it for you. Our experts are going to answer some of those concerns you might have that are a bit quirky, a little bit less, “I can talk to my friends about this or at a dinner party”. It's more, I've got to get on Google and search this up on my own. Whether their patients voice them or not, together with our doctors, we're getting the stigma out of the way and we're getting you on your way to a healthier life. Some of you have sent in voice notes to ask us questions. Terrific, thank you so much. If you want to ask a question, you can visit the website or the link in the show notes and share a voice question. We're going to be chatting to Sydney GP, who's known as Dr Kiis, from army veteran to hit morning radio and director of the Your Doctors network: this is Dr Sam Hay. And you'll also hear from geriatrician Dr Simon Grof as well, and we'll talk about some questions of ageing in later life with him.  But first up, let's meet Sam. Sam, nice to meet you.  Sam Hay: Yeah, you too. How are you?  James Valentine: Yeah, very, very well. I suppose I'm thinking that the relationship with the GP changes as you age. You know, and unfortunately perhaps you start to get to know them really quite well. You see them a lot.  Sam Hay: Absolutely, I think for younger people, they don't fully understand what the worth of a good GP is to them. And then as people drift through their middle years, they certainly start to have more of a relationship.  James Valentine: So let's say post 50, what are the kind of things you'd recommend that we, that I should be coming to see the doctor, once a year, once every couple of years?   Sam Hay: I think there are some people out there who truly are looking after their health very, very well. They have no problems. They're very lean. They exercise a lot. They eat a great diet. They don't smoke. And they have literally nothing going on. And then they come and get a check-up and we literally find nothing. So those people, sure, they probably can go a couple of years between visits to the doctor. But in general, over the age of 50, I like to see patients every single year for a check-up because we want to pick up very early the major risk factors for the big things that are going to cause problems down the track, and those big ones are heart attacks, strokes and diabetes. James Valentine: And what do you pick up? What are you looking for?  Sam Hay: Well, we want to do a general check-up. And in that we're looking at blood pressure, weight, waist, from an examination perspective. Then we want to check the history, how are they going, how much exercise are they doing, what's their smoking, what's their general diet like, what are their stress levels, so where does mental health potentially fit into that. Pretty much all the time we'll do a set of blood tests, and once again, doing a general screen, but trying to pick up the big risk factors that come in, cholesterol, diabetes, a couple of other simple things. And then the major cancers that we need to be screening for. So your major community ones are going to be bowel cancer, cervical cancer, breast cancer, having a conversation with the doctor about prostate cancer screening. But then the last bit overall is we're going to look at somebody's family history. So what have they got in the family that might be putting them at more risk and does it influence all of those things? And do I have to do any other tests?  James Valentine: We've also, you know, again, I'd say if you're 50 and over, you've grown up with the notion you only see the doctor when you're sick. Sam Hay: Correct. And so it's people understanding that check-up is important. Even if the last three check-ups have been completely normal and fine, what we're trying to do is we're trying to pick up your cholesterol or your diabetes or your blood pressure or something else before it falls off a cliff. James Valentine: Yeah. This would make such a difference to you, wouldn't it, Simon, if we were all doing this in our 50s and 60s?  Simon Grof: Oh, absolutely. And I must reinforce that having a good GP is just the number one thing, I think. And we see that in hospitals all the time where some of our older people have not seen a GP for 40, 50 years; there's no-one regular, and just to have that touch point to call the GP who has that relationship and to get some of that background story is just so, so, so crucial. So, couldn't agree more.  James Valentine: Let's look at a few frequently asked questions. Do you see many 85-year-olds still smoking, Simon? Does anyone turn up? They're out for a sneaky… [inhales]. Simon Grof: People do smoke. Strangely enough, I had a virtual consultation the other day and I logged on. An 89-year-old lady, once again widowed, and she had the whole time during the hour-long consultation, and she kept on apologising saying, “I'm sorry it's a habit I can't give up.” James Valentine: And what are you seeing in smoking habits, because we are into a generation that have largely given up, you know, at 50 or 60 or so. Sam Hay: I've definitely seen a drop-off in cigarette smoking and an increase in vaping and a complete misunderstanding about the risks of vaping.  James Valentine: And what's being misunderstood? Sam Hay:  What I find fascinating is, what was it, 50 or 60 years ago, the government was endorsing cigarettes across the world. And then they realised, hang on a minute, these cause disease. And so that, all the governments had a massive flip.  And the community struggles to understand why the government won't endorse these things. Because we don't know the risks. And one of the biggest risks are that we don't really know what these chemicals do when they're vaporised and you inhale them. The second thing is, the majority of vapes that people are using come from underneath the counter, which means they're being produced in factories where you just don't know the chemicals that are in there. So yes, some of the vapes you can get from pharmacies, etc., are going to be more reliable and therefore, for want of a better word, safer, but it's all these other ones that we don't know about. And we are seeing injuries, there are people going to hospital, there are people dying, it's in the media. So it fascinates me that people are still seeking it out.  James Valentine: Yeah. I genuinely believe that anything positive that's being said about vaping is tobacco industry propaganda. But people do say, well, at least it's a way to get off smoking cigarettes. Sam Hay: So this, I think, is the challenging thing because there does seem to be a place for vaping in a harm minimisation program for people who are smoking. So for getting people off the smokes because in vape products that you can get through pharmacies, we have much more reliability about what's in them. We do understand that they seem to be much safer than smoking. So using them in a quit smoking regime, it's generally accepted that they are valuable and useful. For non smokers to take up vaping, still not recommended whatsoever.  James Valentine: Vision. Is this something that you see a lot of that you have to deal with? People start to get cataracts. They start to have eye conditions that they didn't experience before? Simon Grof: Yeah, we do. And as we get older, there are a lot of age related visual disturbances and vision is so crucial.  A story that I can think of, I had a patient of mine who just kept on falling and would present to hospital, would get to the emergency department. There wouldn't be any broken bones, they'd check out the sensation and his power in his body and then send back home. And by the third or fourth time, someone said, let's just give this person a little bit more time in hospital. So it ends up being on my ward and my very astute junior register actually had a look in his eyes. No-one had actually got an ophthalmoscope before and had macular degeneration and off to get some treatments and was, you know, not having any further falls. So I think we sometimes don't think about it. We want to find sometimes the more complex things in medicine, but sometimes it's just taking a step back, being thorough, as what geriatricians and what GPs do, and just making sure you're asking the right questions.  James Valentine: At some point, do you look at people and go, well, this can't be ageing. At another point, a few years down the track, you go, well, this is ageing. Sam Hay: And it's not as simple as that because I think people are maintaining their general health and their fitness for longer. And I think this whole concept of when do you suddenly become old and when do you suddenly start becoming affected by all these old age diseases? It certainly is shifting. I don't tend to look at patients as an age, and therefore this is an age related thing. I tell you, I go, you've got arthritis, you've got a heart problem, you've got a kidney problem, whatever it might be. And just keep it as simple as that.  James Valentine: Yeah, yeah. And I suppose, is there a bit of a trap for the geriatrician as well, Simon? It may not be ageing, it might be something else.  Simon Grof: Yeah, that's absolutely correct. And when in the hospital setting, when my junior doctors are describing and telling me about everyone new that's being admitted to the ward, the age for me is somewhat irrelevant. It's more about their social history, what they're able to do on a day to day basis, where they live, what they can get up to. And it's usually the family that are the worriers still managing their tablets.  As we do age, we do have more comorbidities and their ailments, such as some heart problems, some problems with the breathing, problems with the bladders and bowels. And when you were younger, that didn't seem to bother people too much, but with the accumulation of these, it can be quite difficult to manage as we get older, and I suppose there's a very small threshold.  Whereas, if you were to get a urinary tract infection, that is an infection in the bladder, that can sometimes contribute to problems with peeing, urine to be retained in the body, or it can cause you to go a bit more frequently as we get older. Potentially, a small thing like that can actually have a wide range of issues and complications, and sometimes something like a urinary tract infection, can actually go on and lead to a sudden memory and thinking problems.  And we see that quite commonly, whereas people and older people present to the hospital setting with a urinary tract infection with other things that might be seen as minimal, and they've got a condition that's called a delirium, which is really a sudden change in their memory and thinking with their orientation, with their ability to focus. And that could be quite stressful for both them and for family members, because these things can come on quite suddenly. James Valentine: Over the last few years, we've learned so much about vaccines. You know, it's been such a constant topic of conversation. And it's made, vaccines became age-related, didn't they? Through, during COVID-19, there were various vaccines. Well, you better go and have your boost if you're over 65, and we're going to make that available to you. Well, now you can get your retrovirals if you're over that age, and you know, you better get in and get those. Take me through vaccines for sort of 60-plus. What are you seeing? What can people get?  Sam Hay: I think the general population doesn't fully understand the burden that influenza has. It is a big risk to kids under five and to the elderly bubble of people. There's no magic age group, but we've kind of delineated it at about the age of 65. It's really any adult with any chronic health condition is going to be at high risk from influenza. I am a major advocate for getting your annual flu shot. We need it every year because protection starts to drop off quickly and it's a virus that changes, mutates, so therefore we've got to try and keep up with that, with our updated shots. As we age we get a higher risk of lung conditions and lung infections, you know, pneumonia. And so there's one or two vaccines out there against pneumonia, which are incredibly effective at reducing the number of people that are going to end up in hospital with Simon.  James Valentine: COVID? What's the current thinking on COVID-19? Sam Hay: So people should be up-to-date with their boosters. And this is a conversation to have with your doctor. It really is, to determine what your risk is. So I think people could be up to about their sixth shot if they sort of kept on getting them. But if we go back to the guidelines, they're really saying we only need, from the guideline perspective, three to four shots, definitely. And people could have access to those extra ones. So that's as of the beginning of 2024.  I look at it somewhere in the middle, in that if people have a cluster of medical issues that are going to increase their risk, then they should consider those regular vaccines. If they're looking after people who are at risk, perhaps more boosters. If you're going travelling or into high risk environments, then you may want to consider it.  James Valentine: And what do you see in aged care and among your patients? Are they keen to still get vaccines or they go, ah! Simon Grof: COVID in residential aged care now is still a huge issue and I'm trying to promote vaccines to the older people and their families as well, but you have a lot of people who never took it up to start off with. So you're not going to convince them now, but the people in the middle, the target audience take up these boosters, which are better. Because they do attract and they target against the newer type of variants of COVID. It's more to stop the seriousness of the actual infection and then stopping them presenting to hospitals. So I think in a residential aged care environment, we're still pushing it, which is at odds with what's happening in the community.  James Valentine: At what age am I too young to go and see the geriatrician?  Simon Grof: That's a really good question and that's a question we get asked quite commonly. Essentially a geriatrician is a doctor with specialist training and caring for the health of older people. The term is, I suppose, geriatric medicine. And geriatricians like myself diagnose and treat age-related medical conditions. And the age usually is above 65. But you know what? Really, is it above 65? Most of the people on my ward, or I see in residential aged care, are 85 and above. So, is 85 the new 65? I don't know. James Valentine: Oh, let's not put it that way around. That seems wrong! But there must be many a condition that would have been better off if we were starting to deal with it in our 60s.  Simon Grof: Absolutely. Similar to the heart where, you know, they say middle age is when you really need to up your game and, you know, continue the consistency with the exercise, continue the consistency with eating well, not smoking, alcohol, all the things we hear about. It's similar for the body, similar for the brain, similar for everything into old age as well. So the sooner we can start and the sooner we can look after things, the better it is. And you know, we might be living to 150 soon, who knows.  James Valentine: All right, let's talk about mobility and exercise and bring in sports physician, Dr Mohammad Jomaa, UK educated and now in Sydney, where he's practising as a sports physician. Thanks so much. Mohammad Jomaa: Thanks, James. It's been a real pleasure to jump on and speak to you today.  James Valentine: So what's your general advice for exercise for over 50s?  Mohammad Jomaa: Exercising safely is paramount. It usually is injuries and complications, which stops people from exercising at all in the first place. So we need to use exercise as a means to reduce the risk of our injuries, as opposed to increase the risk of injury through exercise. Doing nothing is bad for us, but we also know that doing too much is bad for us. And so where's the sweet spot? Finding that is all about figuring out where your current function is and very cautiously and gradually increasing from there, giving you enough time to recover and get stronger so that you can keep building and building. James Valentine: So do you have a recommended exercise regime for perhaps, you know, 50-plus?  Mohammad Jomaa: Everyone has a different starting point. Everyone has a different goal. And so exercise prescription is always very nuanced. It's very tailored. It's a science as well as an art. So any good exercise program needs to have cardiovascular exercise, strength training, and stability training. And I'll talk a little bit about each one of those.  Cardiovascular exercise, which is our aerobic exercise, is the mainstay and no matter what our age is, it's very trainable. The bad news is that if we don't maintain it, it will typically decline by about 10 to 15 percent per decade. So about one or one-and-a-half percent per year.  And that can really add up and it can affect the way that we live and the things that we can do as we get older as well. Absolutely everyone should be doing about 30 minutes every single day of what we call zone two exercise. The Australian guidelines call it moderate exercise. Essentially, it's a bit hard work, but if you were pressed, with some discomfort, you could talk in full sentences. And that's the best way to measure that you're in that zone two range. This is essentially our general maintenance, it helps with chronic diseases, and there's lots of evidence that shows that it supports in the management of metabolic diseases like diabetes, cardiovascular disease, reduces our risks of stroke. It actually improves and reduces the risk of cognitive decline and Alzheimer's disease as well. Strength training is really essential to do maybe two or three times per week. Usually we encourage compound resistance, which means hard work, heavy loads lifted or moved around. And this has to be done safely, and so it's always important to have this tailored for you. One of the most common exercises that I prescribe for patients over 50 is that I get them starting to push and pull a sled; we'll find a gym with a sled track. Typically we'll start with around a quarter of the patient's body weight on the sled, and we'll just have them two or three times a week pushing and pulling that sled for 20 minutes.  And it can be really hard work but it also is a very comprehensive exercise as well. And it's really safe. You can imagine if you're trying to pick up something really heavy or carry something really heavy on your back, there's a higher risk of injuring yourself than if you're trying to push something over and you just can't, or pull it over and you just can't. So there's some safety there to that as well.  And then, yeah, finally something that's so important, especially as we get older, is stability exercise. So, stability exercises, the best way to get involved with those are to just join a local tai chi or yoga or pilates or any other mat-based mobility exercise program local to you. With patients who aren't inclined to do that, I talk them through specific balance exercises they can do, standing on one leg, standing on a pillow to make it a little bit harder, and we introduce some movement and instability with that as well. The reason stability is so, so important, and mobility, which is a factor of that as well, is that it's essentially our insurance as we get older. Really major cause of patients coming into hospital and it can be a life-changing event. So it's something to really, really be avoided. And so stability exercises are really important as an insurance against that.  James Valentine: So what about heart health? What's good exercise there?  Mohammad Jomaa: One thing that we're quite well aware of, and this is a great thing for the heart, maybe not so much for our muscles and bones, the heart is always trainable. We can improve our cardiac output, we can improve our VO2 max, which the heart contributes to quite a lot. And that's our ability to consume oxygen and our level of maximal output. When it comes to just general age and ageing, then the main issue with the heart is the development of atherosclerosis, which is the name of the gradual hardening of the arteries in our whole body, but importantly the ones that lead to our heart as well. If you're the sort of person who develops heaviness and tightness in the chest with physical exertion, with exercise, then that's something that definitely needs to be checked out as well. And that's something that your sports doctor will ask you about. Exercise is so incredibly good for us that it's better than any medical intervention really that we can do. There's a lot of evidence that shows that exercise and our underlying fitness are the primary definers of how long we live and how we live towards the end of our days as well.  And so you absolutely have to make it a part of your life as best as you can. Seek help from a sports physician or an exercise physiologist to get you going. Even the smallest amount of exercise for someone who doesn't have an exercise baseline will have huge benefit as well. So if you're someone who's just completely sedentary, there's lots of studies that show anywhere between an hour to 90 minutes of just walking per week, which is, you know, 15 minutes a day, can massively improve your health factors and improve the quality of your life in the medium to long term. So get exercising and stay healthy.  James Valentine: That's very good. I'm thinking, you know, 50-plus, have an excellent 50th birthday. Have a great time. For your 51st birthday, go get a check-up. and start doing an annual check-up after that. Then you're well ahead of the curve, right?  Sam Hay: Yes, but can we bring it forward to the 50th birthday? James Valentine: You want it on the 50th?  Sam Hay:  Yeah, don't wait till the 51st! James Valentine: Let me have the party, you know, then after that I'll go, you know. Sam Hay: Wait a couple of weeks if you have to, then come in. James Valentine: Okay, straight after that. All right, but through your 50s start, start the check-ups. And then with geriatrics, Don't be frightened of it. Simon Grof: We're nice people. We like a conversation. We'll spend time with you, or unfortunately sometimes your GPs can't, and we'll have a plan and we'll work that plan out together. You know, you're not going to be put in a home just because you see one of us. I promise you that. Sam Hay: I've started to explain why I refer people off to specialists in a different manner nowadays.Because some people feel that they're going to see a geriatrician or a knee doctor to get a diagnosis of dementia or to get a knee replacement. Whereas what we're going for is we're going for an opinion. We're going for an assessment. We're going for what do they feel is the problem and what are the potential management or follow-up options?  The patient then decides what they want to do. That's where we need to think of using our specialist more and be freer in just going and getting their opinion and then look at what the management might be down the track. And that's where I use geriatricians for that advice and education and that baseline.  James Valentine: Well thanks to all our experts today, to Sam, to Simon and Mohammad for getting us into the frequently asked and sometimes, you know, a little bit uncomfortable questions. Let us know if any of our doctors today gave you the golden solution to your health's concern. Or did you find out something you didn't even know that you needed to know? We'd love to hear from you. You've been listening to Season 5 of Life's Booming: Is This normal? Brought to you by Australian Seniors.See omnystudio.com/listener for privacy information.

The stigma around menopause is slowly peeling away, but many of us still suffer in silence. In this episode, we take a lighter look at the often unglamorous side-effects of menopause – from hot flushes and brain fog to facial hairs and mood swings – hearing from Aussie comedian Jean Kittson, who is living her best life on the other side, and getting the medical rundown from celebrity GP and passionate women's health advocate Dr Ginni Mansberg. About the episode – brought to you by Australian Seniors. Join James Valentine as he explores the incredible stories of Aussie characters, from the adventurous to the love-struck. Across 30 inspirational episodes, Life's Booming explores life, health, love, travel, and everything in-between Our bodies surprise us in ways we never thought possible as we age, so in series five of the Life's Booming podcast – Is This Normal? – we're settling in for honest chats with famous guests and noted experts about the ways our bodies behave as they age, discussing the issues and awkward questions you may be too embarrassed to ask yourself. Jean Kittson has been entertaining audiences for decades with her wit and humour, both of which she brings to the fore in her candid and hilarious take on menopause, You're Still Hot to Me, the book she wished she had read during the momentous time in her life. Dr Ginni Mansberg is a well-known celebrity doctor based in Sydney, with television appearances in Embarrassing Bodies Down Under, Sunrise, The Morning Show, and Things You Can't Talk About on TV. She is also the author of The M Word: How to thrive in menopause. If you have any thoughts or questions and want to share your story to Life's Booming, send us a voice note – Watch Life's Booming on Youtube Listen to Life's Booming on Apple Podcasts Listen to Life's Booming on Spotify: Listen to Life's Booming on Google Podcasts For more information visit seniors.com.au/podcast. About Australian Seniors Produced by Medium Rare Content Agency, in conjunction with Ampel Sonic Experience Agency SSMR0502_240229_Menopause the other side_Final James Valentine: Hello and welcome to Life's Booming Series 5 of this most excellent and award winning podcast. I'm James Valentine and in this series we're going to ask the question, is this normal? I mean, as we age, stuff happens to us. Our bodies change, things fall off, we get crook, stuff doesn't work as well as it used to. There's nothing we can do about it, we're getting older, we're ageing. But which bits are normal? Which bits do we have no control over? Which bits can we do something about? That's the kind of questions that we're going to be asking in this series, Is This Normal? of Life's Booming. Now, of course, if you enjoy this series, leave us a review, tell all your families and friends about it. And we want to hear from you as well. You can contribute to this. If you've got questions about things in particular that you want to know, perhaps there's some particular wear and tear happening to you, let us know. We'd love to see if we can answer that question in the series. We're going to look at things like menopause, gut health, mental health, lots of other burning questions. So think about those areas and if there's something in there that's specific to you that you'd like us to cover, let us know. When it comes to women's health in older years, it turns out that the hot flushes, the brain fog, the facial hair, the mood swings can all be linked back to the one thing and that's menopause. In this episode, Menopause the Other Side, let's take a look in some detail at the common symptoms, the experiences, and life on the other side of it. We'll get some answers about menopause, the ‘M' word, from the queen of morning television, Dr Ginni Mansberg. But it gives me great pleasure to welcome, of course, to thispodcast as well, Jean Kittson, who wrote a fantastic book called You're Still Hot To Me, dealing with her experience and her research into menopause. Jean Kittson, hello. Jean Kittson: Hello, James.   James Valentine:Still so hot? Jean Kittson: Yes, I am, actually. Every now and then. James Valentine: Is this the 10th anniversary? Is it 10 years since you published? Jean Kittson: Yes, it is. 2014 it came out. It's into its sixth reprint now, something like that. Women still keep going through menopause. James Valentine: The book didn't fix it? Jean Kittson: No, that's right.And I thought I'd finish and everyone's finished. No, they're still going. Of course they're still experiencing menopause. And just the other night I was out with some younger women and they're still struggling. Trying to work out what the best way to handle it is and what treatment to get and they're still people pushing back around different treatments like HRT. I was really surprised. We've come on a lot more than we have 10 years ago, people are speaking about it, but there's still a lot of ignorance really, misinformation. James Valentine: It still seems to be an area of mystery, really, and half whispered truths. Oh well I've heard you should do this, and what about the other? Jean Kittson: Yes, I think people are still afraid it's going to impact on their work because the Australian Human Resources Institute did asurvey and they found that the majority of women would not mention menopause at work because they thought they'd be considered old, sidelined for leadership positions.With all the stigma still attached to menopausal women. So there's still a lot of, I don't want to talk about it in the workplace. And that of course translates to, I don't really want to talk about it at all. James Valentine: Yeah, and leading into it, let's say you're 30 or 40. You're not even thinking about it. Jean Kittson: No, well that's the thing, and yet when I was doing my book, I found that most of the women I randomly chose to interview were having their first hot flushes around 40, 42. And we're always told it's around 50, 52, 55, that area. But many, many women will start going through perimenopause, which is another part of menopause that I didn't even know existed until I went through menopause. So there's perimenopause that can start 10 years earlier. And some women are thinking, they'll follow the Hollywood style. Oh, I'll have a baby. She had a baby naturally at 50. So can I. I'll just keep putting it off. What? Well, was that a hot flush? What the hell? What am I going to do? You know, so it comes as a terrible shock. And I think there's a lot of things about women's bodies that need to be talked about more openly. Fertility, ovulation, menopause, all those sorts of things. James Valentine:Yeah. If only it happened to men. Jean Kittson: If only, we'd never hear the end of it. James Valentine: That's right, we'd have championships in it. Jean Kittson: Yeah, that's right. James Valentine:Set world records, all that kind of stuff. Jean Kittson:You'd have, you know, months off. Yeah. Menopause month off. James Valentine: Do you know, he's battling with menopause but still CEO. What a guy. Jean Kittson: That's right. Hang on, you can't talk to him for a moment. James Valentine: That's right, just wait. Jean Kittson:All the windows are open. James Valentine: He's a little bit emotional but come back tomorrow, he'll be fine. Jean Kittson: We were going to have a board meeting, it's cancelled. But don't worry about it, it's menopause. James Valentine: What? Oh, that's fine, no worries. I went through it myself, man. On you go. Good on ya, chaps. Is it as simple as, like, it was happening to you and you found it difficult to find relevant information, what you needed to know? Jean Kittson: Oh yeah, that's why I wrote my book.I wrote the book I needed. I needed to find the facts out about menopause, and I found out so many other facts about my own body that had never been talked about. We're just sort of more primed, our whole body is primed to have sex when we ovulate rather than other times of the month. But we're told that women are just ready for it every day of the freaking week. James Valentine: Yeah, and let me clarify that. That was men who decided that one? Jean Kittson: Can't say it ain't so. Just because men don't understand women and don't like it when we get a little bit feisty, a little bit irritable, start giving our kids a burnt chop. You know, in the old days, we were diagnosed with climacteric insanity and locked up. And if men of a certain age got a little bit feisty, a little bit irritable, they were elected to parliament. James Valentine: That's right. That's very good. Dr Ginni Mansberg's with us. You've met! Jean Kittson: Yes, we have, Ginni, hello. Ginni Mansberg: Hello darling, how are you? Hello to both of you. James Valentine: Thank you so much for coming. Is this, like, I think what we've got to is, I'm sort of seeing, we shouldn't necessarily think about all these things as separate? It's the entire cycle of life and the entire fertility cycle of a woman that we should be discussing, not as though there's this thing that happens to people called menopause. Ginni Mansberg: Absolutely. I mean, a lot of people don't realise that menopause itself is a single day that happens 12 months from the first day of your last period. Only, you probably didn't know it was your last period at the time because your periods were all over the show, often for up to several years before you go into menopause proper. And we call that perimenopause. I call it hormone hell. Your hormones are giving you a triple pike with a half flip because they are going up and down like a yo-yo, and our brains and our bodies really don't like those fluctuating hormone levels. So often, exactly as Jean was saying, the worst of it comes in your mid to late 40s, not in your late 50s. That's not it at all. In fact, sometimes life gets a lot better on the other side of the rainbow after menopause. James Valentine: Hang on, just take me back. You said a single day, menopause is a single event. Ginni Mansberg: It is. So it's defined as 12 months from your last period.That's really problematic for women who, for example, have a hysterectomy before they go into menopause. It doesn't make any sense for those women whatsoever because their hysterectomy might have been at age 40, their ovaries were fully functional and don't go into decline for another six years. That's a problem for women who use contraceptives like the Mirena coil that have some progesterone in their coil. They don't have regular periods either. So there is a movement to change that definition, but that's what we've got at the moment, that single day. 12 months after you had your last period. James Valentine: Yeah, we describe it, Jean, as it seems to me like it's anything from about 45 to 75, a whole period of life. Jean Kittson: Yes, that's right. That's right. I haven't heard the single daydefinition before, I must say, but of course it is 12 months after your last period, so if you can count to the day, that's the day you are officially, and probably, you know, medically, scientifically, in menopause. James Valentine: What happens on that day? Jean Kittson: You buy a bottle of champagne! James Valentine: Ginni, what happens on that day?   Ginni Mansberg: Mostly it's not a lot different from the perimenopause that precedes it. And those early postmenopausal years, that's why I think getting hung up on definitions is problematic from a medical perspective. It's not like once you hit menopause on that day, everything changes. It's not like that at all. In fact, the treatment is fairly similar whether you've gone through menopause already or whether you're in that lead up, but your hormones are still giving you hormone hell. James Valentine: Jean, when you were looking at this, did you find a treatment for menopause? Jean Kittson: Well, when I started going through menopause, I was asking around my friends, what's going on, and they said, oh, it's probably menopause, and most of them didn't take any treatments, and they said it was a breeze for them, or they didn't really like to talk about it. Some of my friends said, I'm on HRT. Other people were saying, HRT is deadly, you'll get breast cancer. It was during that time. It wasn't long after the Women's Health Initiative brought out the report that linked HRT to breast cancer and everyone dropped off using it.But then it was found 12 years later to be flawed and HRT is the best way to go. So I had to keep being a fully functioning woman. I had kids at home, elderly parents, I was full-time job. I couldn't stand on stage and start perspiring and mopping my brow, and that's the first time I had a hot flush. I was talking to all these young Czech guys from Ericsson or something. It was a corporate gig, and I'm standing on stage in a silk top, gold silk top. And then I'm going, is it hot in here? That's probably the first time I mentioned that, you know, out of the million times I've mentioned it since. And I started mopping my brow, and then I looked down, and my whole top had turned like camouflage. I had rings of sweat under my boobs, I had them down the side, and then I thought,I have to do something radical about this. So I went to a gynaecologist, I talked about HRT, I realised there was a lot of fear that a lot of women suffered, a lot of women would leave their jobs because they thought they weren't coping with work, but they actually weren't coping with their menopause symptoms. I realised it was like in so many aspects, women were afraid, they suffered, there were these taboos, they were without information, they couldn't lead fully functioning lives, basically. And so, their biology was in denial, and one of the reasons they denied their biology and didn't talk about it was because when we were allburning our bras and things like that, we wanted to be equal to men, the same as men in the workplace. We didn't want to admit that actually there's things that are going to happen biologically that are going to affect our jobs. Not for the worse. We just have to work around it. Like we've got the little kitchen tidies in the toilets now. You know, in the old days, men would say, Oh, don't listen to her. She's on the rags, when we got our period. If you said that now, you'd be considered a fossil and a twerp. So we've got to get the same with menopause. So there's lots of great treatments, but Ginni would know. James Valentine: Ginni, we might come back to treatments. Let's just discuss the symptoms. First of all, you know, Jean's first moment is ghastly. Thank you for repeating it. But the range of symptoms is also extraordinary, isn't it? Ginni Mansberg: Yeah, everything from palpitations to shortness of breath to itchy skin, a whole lot of stuff that goes on below the belt. Hot flushes is the one that most people know about and that's because it's really common and very visible. So 75% of women will experience those hot flushes. They're not always dramatic, like Jean's. Some women just run hotter and a lot of women experience heat at night, so that interrupts their sleep. We see a lot of insomnia. About 80% of women will experience what we call brain fog. So you can't remember, oh, what's that thing that you write with that leaves ink on the page? Can't remember the name of it.What's that thing that I need to get into the lock of my house? Can't remember that thing. Forgetting people's names, being on a Zoom call and forgetting the name of the project you're working on, that 80% of women will have that, but a lot of people don't realize that this is peak time for mental health issues in a woman's life. So one in three women will experience some sort of mental health problem. Anxiety and depression are the main ones, and they have particular hues. We often call it the ‘peri rage'. People are just so angry and so annoyed, and they don't understand why they're so angry with people, but lashing out and acting what they feel like is very inappropriate. They're very remorseful and quite paranoid, very thin skinned, very easily offended. Now, when you put those things together, it's not surprising exactly as Jean says, that untreated, 10% of women will leave the workforce altogether at this time, an additional 14% will decide to go part time or to significantly reduce their hours, an additional 8% of women will either ask for a demotion or actively avoid a promotion, say no to a promotion that's offered to them. And then we can't understand about number one, the gender pay gap, but number two, the fact that Australasian women retire with so much lower levels of superannuation and the Australian Institute of Superannuation Trustees has estimated that for Australian women alone, menopause costs between $17 and $35 billion a year in lost revenue and lost superannuation because they are exiting the workforcebecause of this hormonal glass ceiling. Now that doesn't happen to everyone, but I think that those numbers are costing the Australian economy enough and women enough that we need to be taking it more seriously and not just saying it's a couple of hot sweats. Suck it up, princess. James Valentine: Yeah. But I think Jean highlights the difficulty here for many women is to say, is that unless the society acknowledges it, unless the entire workforce and all of our structures acknowledge the existence of these things, it's very difficult for an individual woman to suddenly say in the workplace, actually, can we just deal with my menopause?Um, you know, is that okay? Can we accommodate that now, please? Ginni Mansberg:I think we really need to talk about the study that Jean talked about called the Women's Health Initiative Study that came out in 2002. So if you allow me just a couple of minutes to explain what happened and why we are in a bit of a disaster today. So untilthat study came out, around the 1990s, big cohort studies – so when you look at big populations – what scientists had found was that women who were taking the older forms of HRT had lower levels of heart disease. And so the National Institutes of Health in America decided to mount a massive study, 110,000 women, that was a prospective placebo controlled trial. Don't worry about the details. It's just a really, really good study. And they took women with an average age of 63 who had never had hormone therapy and gave half a placebo and half hormone therapy to look at what would happen to their rates of heart disease and other illnesses. What they didn't expect to find was this. For every 10,000 women who took a placebo, there were 30 cases of breast cancer. But for every 10,000 women who took this old-school form of HRT that we no longer use at an average age of 63, when the vastmajority of women are well past their symptoms and don't need it anymore, when they started it at that age, there were 38 cases of breast cancer per 10,000 women. The result of that finding was that, and on top of the fact that no, they didn't have any less heart disease, they decided to cancel the study. But instead of talking about those relative risks and the fact that this was not in the population that used hormone replacement therapy in real world trials, they went to the papers and said, hey, this stuff causes breast cancer. And a fewthings happened as a result of that. Number one, 80% of women worldwide threw their HRT in the bin and all the menopause symptoms got rebranded as just like a wrinkle, like a bit of, if you can't handle that, you're a princess. You shouldn't need this stuff. It's very dangerous. The second thing was, and this is really important.There's a legacy of this today, was the doctors were no longer taught about menopause. It went out of the curriculum. I, with all of my postgraduate experience, have never had any formal education on menopause. Everything I know is self taught by joining the various menopause societies around the world because it is not taught to medical students.It's not taught to GPs. It's not taught to gynaecologists these days. This is a real problem. There are also still black box warnings that exist today on the newer forms of HRT that women are likely to be prescribed that don't even have that increased risk. In fact, with that study, if you took the subset of women in that 110,000 women study, who took the HRT at anaverage age between 50 and 60, there was no increased risk of breast cancer. So in the real world, use of that old school HRT, there was no increased risk of breast cancer. But the legacy today means that women are told that it's a shameful thing to ask for any help for it. You shouldn't need it because the treatment is dangerous. It makes women think that getting treatment for it isputting their own lives at risk. It also means that doctors are not skilled up to help women in this situation. And research, you know, there was no research that was done on this topic for decades. That is starting to turn around as women like Jean, who really was a pioneer in 2014 when her book came out, nobody was talking about it. And she really, really smashed that stigma. We can't thank you enough, Jean. But as doctors in my generation, the Gen Xers, hit this age group ourselves, we're going, hey, what the hell? What the hell happened to our medical education, and how have we let women down so badly, which we have. I think we're turning the corner, but I just wanted to explain the background for why we are where we are now. James Valentine: That is riveting, andI mean, Jean, I almost don't know what to make of that. You know, when you say, a gynecologist isn't trained in this, a doctor today. You mean a doctor today, sitting in medical school, how'd they come after the end of six years, and at no point did anybody say, right, this term, menopause. Jean Kittson: There's a woman called Professor Susan Davis in Melbourne, and she's training doctors in menopause and more women's health, but there wasn't a subset of women's health. And I don't think there ever was one, because I remember this gentleman, he was about 70, coming up to me at a book signing.And he said he was a GP and he said he trained in the 1960s in England. And he said, I'd like to buy your book. Because I've never, he said, the only time at medical school that menopause was ever mentioned was when we were sitting in a lecture theatre, all men, mainly men, sitting in a lecture theatre. They wheeled a woman into the centre of the lecture theatre, a woman of a certain age. And, um, she was introduced as a menopausal woman. And she looked around and she said, my husband doesn't bother me anymore. And that was it.My husband doesn't bother me. So, that was her, that was their lesson in menopause, that obviously women just go right off sex, that's it. You know, nothing else. James Valentine: That's the most crucial factor that happens in the whole thing. Jean Kittson: Yeah. But importantly, what Ginni's saying about the study that linked HRT to breast cancer, there was a new study that came out in 2012, so 10 years later, that explained why it was wrong and what Ginni was saying.As you get older, you're more likely to get breast cancer anyway. So they were using people into their 70s in this study. But what happened was when women threw away their HRT was doctors started prescribing antidepressants to deal with it instead. So we have this huge sort of flood of women on antidepressants because they felt confident with that.They felt if they prescribed HRT and their patient got breast cancer, they could sue, you know, it was all up in the air. There was a lot offear in the medical world. So now all these women are on antidepressantswhen what they're experiencing once again is what Ginni said, hormonal fluctuations. Ginni Mansberg: Anxiety is more common than depression during the peri and menopausal years. In fact, trigger warning, one in three women will get this anxiety and depression. It is peak time for anxiety and depression in a woman's life. It's also peak time for suicide in women is 45 to 55. And it's clearly a hormonal thing. And we very rightly in this country focus a lot on postnatal depression. And we don't focus enough on midlife women's depression. What we do see is that if you did have a history of previous hormonal anxiety and depression, on the pill, postnatal, it'll almost inevitably come up again during this period, this perimenopausal period. But we see it a lot in women who have never experienced it before, and severe depression, like a lot of these women can be hospitalised. What we also know, exactly to what you were saying, Jean, about the use of antidepressant medications, at best they are about 75% effective, which is better thannothing.But they do leave 25% of women or people in general who don't respond to them. That level of effectiveness goes down to around about 50% in women who are going through perimenopause and menopause, whereas the hormone replacement therapy is in fact, 76% effective. So nothing is 100% effective, but this is clearly a hormonal issue. And if you speak to Professor Jayashri Kulkarni, who is from the HER Centre at Monash University, who is a world leader in menopause andall psychiatric disorders. Her first port of call will always be a hormone treatment and she will only bring an antidepressant medication in if somebody has severe symptoms, for example, they're suicidal or they can't function or they literally need to be hospitalised and that will only be for a short time and then she gets them off it again and they stay on the hormone replacement therapy. So it's a very different treatment now to what we used to do only 10 years ago, even just when your book came out, Jean. James Valentine: Jean, I think you highlighted another aspect of this is the time of life at which this occurs. A woman is going to very often have perhaps teenage children,children moving into adulthood. She might be starting to go really well in her career. Her parents are now 70 or 80. You know, there's a lot going on at the point at which this hits. Jean Kittson: Yes, well, women really are at their peak now in their careers. Once, a hundred years ago, the average age of mortality of a woman, a woman would die at 57, so you hit menopause, you die. Menopause is the least of your problems. But now we're into our late 80s, mid 80s, late 80s. We've still got a third of our life to live and we still are working and running a family and the kids are probably still at home and we've got our elderly parents. Just as you say. So the time of life when menopause hits is really a very intense time of life for women.There's so much going on. And you may finally be getting into the position at work where you're feeling really comfortable and you know what you're doing. You have all this knowledge and expertise and understanding, and thensuddenly you're battling with something physically that is undermining your ability to manage all these different aspects in your life. And you have to micromanage so much stuff in life. And when you're not getting sleep, I think that's probably one of the worst things, not getting sleep. Then your anxiety and everything, it goes up. Because you're waking up during the night with these hot flushes or night sweats or whatever you want to call them, that's why you really need to get some proper support. And now we know, I went on HRT for 10, 12 years, it was fantastic. I couldn't have managed without it. I felt really good. And now there's so much information that it's good for your bowels and your heart and your brain and youreverything, isn't it? Your skin. There's so many things it actually helps in a woman. James Valentine: Ginni, is HRT the only treatment? I mean, people will see a range of stuff that's beingsold to them or is available. Ginni Mansberg: Yeah, so there are womenwho can't have HRT or don't want to. And I think what I'm passionate about and a lot of doctors now are passionate about is autonomy of women to have their own choices and HRT is one choice and if women choose not to or can't have it because they have a breast cancer which has what we call oestrogen receptors on it then we give them HRT and there's a possibility we can actually make their cancer worse. So not everyone can have it. In that situation, we need to have a range of issues. What I love about HRT is of the 53 symptoms that we've so far identified, everything from palpitations and itchy skin to incontinence, and of course, your hot flushes and your depression. It's the only one that wraps up, I guess, every single symptom and helps every single symptom. That's what's nice about it. However, a lot of women don't even have a lot of symptoms. So what we can do is target your symptoms individually with different medications and antidepressants is definitely an option, although none of them are as effective as hormone replacement therapy. Because menopause is having a bit of a moment now, but because women are still left with this lingering doubt about the safety and efficacy of hormone treatments, there is a whole raft of products that have come to market promising all sorts of symptom relief, mainly in the supplement space, but also in the tea space, in the wellness powder space. Promising a whole lot of things that we have fairly good evidence do not work whatsoever. But, once you put an ‘M' on it, and put a pink bow on the cover – we call it ‘meno-washing'.You're going to now charge double for a menopause herbal product than you are for a normal herbal product. Because women are vulnerable, plus we are pretty good consumers. We are generally now, us Gen X women, prepared to go and buy things for ourselves if we think they're going to contribute to our wellness. So my concern is if you are going to buy one of these menopause products, I would really run it by a doctor who has experience in hormone replacement therapy. And other menopause management, a lot of women will get a placebo effect. In fact, in studies, it's up to 75% placebo effect. In my experience, you'll get a good six to maybe 12 months out of a placebo effect. But meanwhile, you're getting to the point where, do you remember I talked about the Women's Health Initiative and I told you that the women who started it late ran into problems. That's the best thing that came out of that study. We know if you are over 60 or if it's been more than 10 years since your menopause, you can't start HRT anymore.It confers a very big number of risks for you. James Valentine: Well, it seems to me, Jean, we started saying your book is 10 years old. So this is one of the firstvolumes and first statements to break through a lot of taboo about it, a lot of non conversation. You said, look, things are a little better. We've come some way. I'm not feeling that necessarily by the end of this conversation. It seems to me so much further to go. Any one thing you want to happen right now? Jean Kittson: I would like women not to just google menopause because then they will get so much misinformation.There are really reputable organisations with the correct information, with the facts, and that is places like the Menopause Society that Ginni mentioned, the Jean Hailes foundation, Ginni's probably got a finger on more of them now, I don't go to them, but both those places have the facts. Get the facts because there's so much misinformation and it's really controllable. It's a great time of life. If you can get a good sleep and you haven't got the anxiety and you've got control over that, it's wonderful not having to fork out all this money on sanitary products. And you can wear white jeans again, you can go swimming without fear of attracting sharks, it's brilliant. The whole thing is really very, very liberating, but take control over it. Get the right information, get the facts. Don't just chat to people and try and get it that way, becausethere's so much misinformation. James Valentine: Yeah. Ginni, any one thing you want to see happen right now? Ginni Mansberg: Yes, if you head to the Australasian Menopause Societywebsite, and then click on find a doctor, you will find a doctor who has a particular interest in menopause and is unlikely to give you the sort of like, oh, you can't have HRT, it's dangerous, kind of advice that I'm still hearing every day. We have made, Jean and I have made, menopause sound absolutely horrendous, which untreated it is. Treated, it is not. Treated, you have a normal life. You do not need to leave the workforce. You do not need to end your marriage. It is peak time for divorce. You don't need to have a fight with your best friend or sister. You can actually have a normal life. And I would urge women not to see this as an inevitable and natural phase of life, so just something to be borne by women or just seeing it as there's nothing you can do. There's so much we can do for you. Please let us help you and let you get your life back because you don't need to just put up with it. James Valentine: Thank you so much. Fabulous conversation. Thank you so much for sharing so much information and experience with us here on Life's Booming. Jean Kittson: Thank you, James, for the opportunity to keep talking about menopause. Talk it up! Ginni Mansberg: Thanks, guys. James Valentine: Well, if you want to know more, you could do no better than to read Jean Kittson's book You're Still Hot To Me.As we said, it's still out there. It's still a very vital book examining the conditions for menopause in Australia. And Dr Ginni Mansberg's book is called The M Word, and it's doing the same thing. It's looking at the medical basis, as we keep saying, the facts about menopause. Well I hope you enjoyed this episode of Season 5, Life's Booming, Is This Normal? Brought to you by Australian Seniors.See omnystudio.com/listener for privacy information.

Changes to our joints, bones and muscles are often attributed simply to ageing ‘wear and tear', but is that true? From creaky joints to hip and knee replacements, physiotherapist Rod Grof takes us through the top musculoskeletal risks as we age, while Logie-winning actor John Wood shares his own health story, and how health impacts his life. About the episode - brought to you by Australian Seniors.  Join James Valentine as he explores the incredible stories of Aussie characters, from the adventurous to the love-struck. Across 30 inspirational episodes, Life's Booming explores life, health, love, travel, and everything in between. Our bodies surprise us in ways we never thought possible as we age, so in series five of the Life's Booming podcast – Is This Normal? – we're settling in for honest chats with famous guests and noted experts about the ways our bodies behave as they age, discussing the issues and awkward questions you may be too embarrassed to ask yourself. Acting veteran John Wood is no stranger to treading the boards. From Rafferty's Rules and Blue Heelers to comedy revue Senior Moments and Ensemble Theatre's newest show, The Great Divide, John has been entertaining audiences for more than 40 years. Rod Grof is a Melbourne-based physiotherapist and principal of Platinum Physio. Experienced in treating a range of musculoskeletal injuries and conditions in clients across the lifespan, Rod helps his older patients to live more active lives, with less pain. If you' have any thoughts or questions and want to share your story to Life's Booming, send us a voice note - lifesbooming@seniors.com.au. Watch Life's Booming on Youtube Listen to Life's Booming on Apple Podcasts Listen to Life's Booming on Spotify Listen to Life's Booming on Google Podcasts For more information visit seniors.com.au/podcast. Produced by Medium Rare Content Agency, in conjunction with Ampel Sonic Experience Agency   Transcript: James Valentine: Hello and welcome to Life's Booming Series 5 of this most excellent and award winning podcast. I'm James Valentine and in this series we're going to ask the question, is this normal? I mean, as we age, stuff happens to us. Our bodies change, things fall off, we get crook, stuff doesn't work as well as it used to. There's nothing we can do about it, we're getting older, we're ageing. But which bits are normal? Which bits do we have no control over? Which bits can we do something about? That's the kind of questions that we're going to be asking in this series, Is This Normal?, of Life's Booming. Now, of course, if you enjoy this series, leave us a review, tell all your families and friends about it. And we want to hear from you as well. You can contribute to this. If you've got questions about things in particular that you want to know, perhaps there's some particular wear and tear happening to you. Let us know. We'd love to see if we can answer that question in the series. We're gonna look at things like menopause, gut health, mental health, lots of other burning questions. So think about those areas and if there's something in there that's specific to you that you'd like us to cover, let us know. From creaky joints to hip and knee replacements, let's find out the things that are really gonna affect our muscles and our bones, our musculoskeletal system. Someone who knows muscles a lot better than me is Melbourne based director of platinum physio, Rod Grof. Rod helps his older patients to live more active lives with less pain and he can share what commonly happens to our bodies as we age and also what we can do about it. But before we bring on Rod, let me introduce someone who's very familiar to you. You're gonna know him. He's a great guy and a marvellous actor. You got to know and love him in Blue Heelers. He's currently in the ensemble theatres The Logie winning actor. Hello, John Wood.  John Wood: Hello, James. How are you?  James Valentine: Good. You're a bit crook.  John Wood: Oh, I'm not that crook. I've had Rheumatoid arthritis for about the last 15 years and it sort of slows you down.  James Valentine: What did you first notice?  John Wood: Pains in the ankles, really. You know, quite severe pains in the ankles and difficulty getting around. And then I started to notice it in the hands, you know, like it was, you know, the knuckles were really swelling up and the hand was very difficult to move, but I also discovered I had Gout in, certainly in this hand, this hand I had an MRI done on and it was full of uric acid. James Valentine: Yeah, right. And were they, what did they say at the time, was that compounding, were they separate things or compounding one another?  John Wood: Well, they're separate and you take different medication for them both. I mean, you take allopurinol for the gout and methotrexate for the arthritis and I've started taking curcumin recently, which seems to settle things down a bit, and mersynofen.  And this week, I've had, I don't know why it's happened, but I seem to have something like bursitis. There's no lump or swelling or anything, but the elbow has been giving me jib James Valentine: It just happens. It's like, what do you do? It just happens, doesn't it? Everything starts to go a bit. How long a period, like from say the ankle pain to the joints, are we talking months, years?  John Wood: Not very long. It was, it just seems that I've got Rheumatoid everywhere. You know, like it's, apart from slowing me down a bit, it hasn't really affected my work, except for one occasion I auditioned for the Harry Potter musical and they had us marching up and down and across and sideways and doing all sorts of stuff and that was all fine, then this associate director from England said, now I want you all to fall down. And I said, I can't even get on the ground to play choo-choo trains with my grandkids. So I said, it's a big mistake getting me to fall down. He said, nevermind fall down anyway. So I fell down and I had to be helped up by Julie Forsyth and a couple of other women. James Valentine: And so it doesn't impede you that much, but it's painful. John Wood: It's always very painful. Yeah. But at the moment, it's not too bad. I guess you get used to it as time goes on. And I've been lucky that the methotrexate has stopped any, you know, the stuff that says swelling.  James Valentine: Yeah. It doesn't seem to be there.  John Wood: No, no. And you know, I remember seeing old ladies when I was a kid, you know, whose fingers were really gnarled and bent.  James Valentine: And sort of folded into a claw almost.  John Wood: Yeah, yeah.  James Valentine: It's shocking. And so apart from the drugs, what else have you, what else have you tried? Exercise, diet?  John Wood: Oh I'm trying, I'm staying at Kirribilli at the moment of course, and it's a bloody long walk up to the shops at Milsons Point. Just about, you know, like I'm getting fitter.  James Valentine: Well let's bring in Rod. He's Director of Platinum Physio and he helps patients like you, you know, with, I suppose, the non chemical approach and trying to get that bloody long walk to maybe go a bit bloody further.  Rod, thanks for joining us. What are you hearing and what John's telling us? Rod Grof: I'm hearing a very common story. We have plenty of patients who come into our clinic with Rheumatoid arthritis. And you said John, 15 years ago was your onset of it. So often we hear that Rheumatoid arthritis' onset is between the ages of 30 to 50 years of age.  And you're currently taking methotrexate: just for our listeners, that's actually a immunosuppressant, so it's going to slow down the immune response and in turn reduce, hopefully reduce the inflammatory response as well. And starting in the ankles, that's fairly common, but more so starting in the hands and the feet is probably the first point. And then it progresses to the knees, the ankles and as you've mentioned now, the elbows.  James Valentine: You think the elbows are Rheumatoid?  Rod Grof: There's a very good chance that it would be, yes.  John Wood: Oh great, right.  Rod Grof: But again, without a proper assessment, we can't categorically tell you that. But just interestingly that you mentioned that, you know, when James asked you about the exercise side of things, there's some really great non pharmacological interventions, John, that you could really get involved in.  And one of them, which I could speak really highly about would be something called hydrotherapy, which is exercising in warm water at approximately 34 degrees Celsius, and just being able to really get a good workout and have a really targeted workout, which will address your muscles as well as your tendons and your ligaments that are ultimately affected by Rheumatoid arthritis to help improve things like your flexibility and we need to know, have you noticed that you've had changes in your flexibility, your mobility over the years?  John Wood: I've never been all that flexible. I had, I was told when I was in my early teens, I had back trouble and the doctor discovered that I had two L5 vertebrae and I, you know, like most men, I used to use my spine like a crane and just, you know.  James Valentine: And so is that like, so during the course of the rheumatoid arthritis, say the last 15 years, has anyone suggested exercise or anything apart from drugs? John Wood: Well, I was doing my own exercise. I was walking in the RACV club pool at a place called Healesville in Victoria. And it's really great exercise because it's 1. 2 meters deep. It's a heated pool. It's not heated to as warm as Rod suggested but, it's great. I mean, you know, walking through water and I used to do it. James Valentine: That was sort of self prescribed, wasn't it? You just thought this is good. John Wood: Yeah, yeah. I just thought this is, you know, like the water takes a bit of weight off the joints.  James Valentine: But no one has said at any point, you know, when you go back to get it checked or, you know, no doctor or anybody else has said anything, just go and have a chat to the physio.  John Wood:No.  James Valentine: No. No. You hear that a lot, you know, a lot of people don't know what you can offer, Rod.  Rod Grof: Yes, that is the case. And our physio association are really pushing forward the campaign just to give the general public to get a good understanding of the breadth of what we do. And it's not just about musculoskeletal. We also treat patients neurologically. We also treat patients, you know, cardiothoracic wise as well. So there's a lot that patients don't know that physios can do except for massaging, you know, Chris Judd on the sidelines at an AFL game.  James Valentine: Yeah, yeah. Or, you know, or actors who need a little bit of help. Rod Grof: Yeah, absolutely.  James Valentine: Can't get up off the Harry Potter stage at any point. So would you consider it now, John? Like, you know, like we can go in a little bit more about what it actually offers. Are you open to stuff, you know?  John Wood: Yeah, yeah, of course I am. Yeah, yeah. I'd be very happy to talk to Rod. I believe you're in Melbourne, so.  Rod Grof: Yes, I'm based in Melbourne. John Wood: I'm just here, up here, working at the moment.  James Valentine: So Rheumatoid arthritis, how common is that? Rod Grof: Rheumatoid arthritis is fairly common. It's a condition which is an autoimmune disease, which basically means that your body essentially is attacking itself. It's malfunctioning. And it's different to other forms of arthritis or the more popular or more well known type being osteoarthritis, which is more of your wear and tear type of arthritis. With Rheumatoid arthritis, that is when the body is actually attacking the lining of the joints, and that causes the redness, causes the swelling, and really a significant amount of pain and loss of function. James Valentine: Then that would suggest to me it's kind of curable. You know, can we take something to fix it?  Rod Grof: So sadly it actually isn't curable. However, it can be managed. So that's where I come into the picture. The non pharmacological side of things is you know, exercise, good sleep nutrition, stressing less, having a really good lifestyle and being active; yoga, meditation, mindfulness, all of these things are really important to help manage that condition from a non pharmacological perspective. And when you go and see the quacks, see the docs, they're the ones that are going to feed you all the different pills. And I always say this, if there was a pill for exercise, every single doctor would be prescribing it.  James Valentine: Yeah. But in some ways, it is the hardest one to do if you don't, if you haven't had a discipline of it in your life, it can be very hard to start.  Rod Grof: Absolutely. You know, we have plenty of patients that come through our door that are across the lifespan and some of them have never walked into a gym in their life. An active gym is a real central feature of our physiotherapy clinics.  James Valentine: So what's going on in this gym? What are you doing?  Rod Grof: So in the gym we're actually completing some physio supervised exercise. So we're actually taking the patient through a Physio tailored exercise regime, which addresses whatever their deficits are.  James Valentine: We said, you know, if you haven't had exercise as part of your life, where you're not used to gyms, maybe that can be a bit forbidding. I mean, the other difficulty that can come with ageing is that you're not as limber as you once were, or you've got another injury or a knee problem or something that may interfere with you doing the exercise. Rod Grof: Absolutely. So often as well, having other niggles is a massive deterrent. And again, we've had patients that come in all the time and say, look, I used to be a runner and you know, I unfortunately was climbing a ladder one day and doing some housework and I fell off the ladder and I landed on my knee and I had to go to surgery and I had to go to hospital and have surgery. And unfortunately that moment in time has really prevented them from going on to do any form of exercise or rehabilitation. Whereas that's the time that should really be the impetus and really give you that motivation to start getting better because there's just so much that can be done.  James Valentine: It's common at this point to start to have, I've got a bit of a creaky knee and a bit of a dicky hip and my elbow is a bit weird when, you know, the sun's at 45 degrees and I just played tennis three days ago. You know, it can all feel a little bit ill defined or you've had a bit of a go at a couple of things and nothing much happened or changed. That's what it can feel like at this age. Hang on. I'm describing myself. You know like and you're not sure whether to seek treatment for every creaky bit that's that's going on.  Rod Grof: Yes, so what you're describing is, you know, noisy knees is a great example. The reality is if it's not painful and not affecting your quality of life, just play on. Don't worry about it. We become so obsessed and we hear so much about, you know, bone on bone and my joints are creaking and cracking. Well, there's plenty of evidence that suggests that people who are bone on bone actually don't have any pain. And there are those that have pristine looking joints, and can't get off a couch. So based on that, there's really good evidence, really important lifestyle choices that you can still make. And based on that, we would encourage you, even if you're hearing all these interesting sounds in different parts of your body, work through it, and if it's progressively getting worse, that's when you do seek treatment. James Valentine: Do you start with the physiotherapist? Do I go to a GP? Do I go to some other doctor and then get referred to you?  Rod Grof:  It's a great question. Now, I believe when it comes to musculoskeletal related conditions, go straight to your physiotherapist. Here in Australia, you don't need a referral, so it's very, very accessible. Often we'll have patients that will go to a GP and the GP says you need to go see a physiotherapist straight away. Also, there are some GPs though, that might go, Oh, okay. You've got a bit of a creaky shoulder. Maybe we need to go and do an X-ray or do some imaging. So I've seen people walk through my door with a wheelbarrow worth of scans. I'm talking about scans, including X-rays, MRIs, CT scans, ultrasounds over the last 20 to 25 years in relation to whatever joint it is that's bothering them. Now, these people have done the ring around. They've gone doctor shopping and seeking answers and they come through our door because this one doctor in the last 20 years who they've seeked has said, why don't you go and see a physiotherapist? So they come into our door and the first thing we ask them is, have you ever seen a physio? They say, no. Have you ever done any form of exercise? They say no. Okay. Well, great. Here's a starting point. And I try to soften it. I didn't say we've got a gym out here. Let's go and do some gym work because again, the idea of going into a gym can be quite terrifying for people because they think of macho men with their tops off and flexing their muscles in the mirror. So just to sweeten it up a bit, it's more of a rehabilitation center and that just kind of takes the edge off it a bit. And that way we at least get that buy in and introduce them into that gym setting. Let's talk a little  James Valentine: bit more about the difference between Rheumatoid and Osteoarthritis, because I think we've spent a fair bit on Rheumatoid. Osteo comes on when in your life, what's it caused by, what is it?  Rod Grof: Absolutely, so Osteoarthritis occurs, you know, pretty much over the age of 40 years of age. There's different degrees of it, different stages of it. It is a Progressive condition and you know, it's, it's part of the, unfortunately it's part of the ageing process. Like we get gray hair, like we get wrinkles, that's all age related changes. These things are common with arthritis where ultimately, or osteoarthritis, where the cartilage that lines the joint changes.  And that can be as a result of different mechanical stresses that you put through your joints and more commonly, wear and tear and genetics, you know, unfortunately we can't really fight genetics.  So one of the biggest, I guess, risk factors that you can't change for arthritis is your age, your sex, and also your genes. When I say sex, it's more common in females than it is in males. Now arthritis, unlike Rheumatoid arthritis affects more of your major weight bearing joints, i.e. predominantly your hips and your knees.  Okay. And again, you might get sensations of what you described before, which was the noisy sounds. We call that crepitus. That's the medical term for it. Specifically, you might get some bony enlargement as well around the particular joint that you're working with. And unfortunately there are factors as well. The other risk factors that are actually modifiable are things like improving your muscle strength. Improving your level of physical activity and also again, just ensuring that you're living a healthy lifestyle.  James Valentine: Yeah. So when this first occurs, can you slow it down? Can you end up, can you get rid of it?  Rod Grof: So again, you can, it's not that you can get rid of osteoarthritis. However you can slow it down and you can by doing all of those modifiable, implementing most of those modifiable factors, as I said, particularly exercise, weight loss is a really big one as well. And by the way, this is quite an interesting fact, which I'm sure your audience will find very interesting. For every 10 percent of body weight that we lose, there is a 50 percent reduction in the amount of loads going through our knee joints.  James Valentine: Yeah. Well, that's amazing. So I lose 10 kilos. It's like 50 kilos less through my knee. Is that what that means?  Rod Grof: So it's 50 percent less load going through the knee. So as a great example, I had a gentleman who I saw last week and I've been seeing him for the last few months. He came in initially with significant knee pain referred by an orthopedic surgeon for physio prior to having a knee joint replacement. And we had our discussion about what are the first line of interventions and treatments that we can do to assist you and hopefully potentially slow down the process or delay the operation. But again, he was on a wait list. So in his mind, it was happening. I go to him, do me a favor. Let's try and lose 10 kilograms. Go consult with a dietitian and let's get you onto an exercise program which consisted of twice weekly exercise under physio supervision as well. And this patient now came in last week. He weighs 90 kilograms. He couldn't walk. He couldn't get off his chair without pain. He couldn't walk around the block. He couldn't go to his letterbox.  And now this guy is walking and getting up and picking up his grandchildren off the floor completely unrestricted. It's quite astonishing. And he's a really great example of what, you know, physical activity and looking after yourself and being motivated can do. So he's actually now completely called off that joint replacement. James Valentine: Now for many, it will end up in surgery. Is there an ideal age? Is there a right age for this sort of thing? What are the conditions in which you would go well, okay, yes, you're going to have to replace the hip. You're saying that it's hips and knees that get most affected by osteoarthritis. So that's the things we tend to replace, isn't it? Rod Grof: Absolutely. So the most common areas of the most common joints that get replaced are our hips and our knees. So at what point would you get the operation? Again, everybody's different. Typically these operations have around a 15 to 20 year lifespan as well before you have to go in again and get it revised. And that can be quite a big procedure and one that, you know, surgeons are happy to do, but if you can delay it, the better. So ideally, 65 to 75 year olds are the most common age bracket that will end up having a joint replacement. Any earlier would suggest that your arthritis has progressed quite significantly and it needs to really affect your quality of life because at the end of the day, it's not a magical bullet. It's the last resort. As in terms of the triage of what needs to be done, education, exercise, weight loss is number one. The next phase is looking at things like injection therapy, taking pain relief, taking anti-inflammatory medication. And again, if that's still not giving you the quality of life that you're after, that's when you look at having joint replacements.   James Valentine: Rod, let's just think about other general wear and tear things that happen at this age. We've, we've talked about hips and knees. We've talked about the two main arthritis things. What are the other main sort of physical wear and tear we're going to expect? Rod Grof: Sure. So our tendons, which connect our muscle to our bones, different bodily structures that with time, they go through that wear and tear process as well. And again, the solution to ensure that you don't have any issues like what we call the medical term for a previously was known as tendinitis. Now it's actually been changed to a tendinopathy because we know there's not really inflammation per se in the tendon. But the issue is the actual genetic or the makeup of the tendon as we get older, the collagen fibers become a bit more frayed and disorganized, and that is part of the aging process. So again, what's the solution for it? James Valentine: Can I guess, can I have a shot at this? Let me see. Might it be exercise? Might it be some resistance? Could diet be a factor here?  Rod Grof: All of the above. Fantastic. So it's pretty simple.  James Valentine: I've been listening so far.  Rod Grof: It's a very simple solution. And again, I can't emphasize, and you can hear my passion about what I,  this is why I do what I do. My motto is to keep people active and healthy, to live the life they love. And by doing so, We're able to ensure that they can pick up their grandchildren, go for a walk with their friends singing Taylor Swift around the park, and really have a really great quality of life and enjoy the last 30, 40, 50 years because here's no reason that we should let age get in the way. James Valentine: Let's bring John back in. John, is it, you know, anything in particular that you want to, you've been listening to the kind of conversation we've been having, anything you want to ask Rod? John Wood:  How does one go about visiting you? I mean, I would be very happy to come and have a chat at some point.  Rod Grof: So if you want to come directly to the clinic or directly to any physiotherapy clinic. I would ask a few questions cause some clinics don't necessarily offer management of Rheumatoid arthritis. It might be slightly out of their scope.  James Valentine: And there's simple sort of exercises you'd start with. What would be, if he signs up, what would be some of the first things he might be doing? Rod Grof: So look, mainly the exercise that we'll focus on initially would be in relation to just improving your overall mobility and giving you a structured walking program as well and just gradually. Increasing the distance, the time over a period, because we know going too hard too soon can actually have worse outcomes as well. Especially in over 65s, balance is a really big issue. We know that one in three people over the age of 65 fall.  John Wood: Well, you know, I have noticed that I'm more prone to falling over, not being able to get my underwear on, stuff like that.  James Valentine: All right, well, you know, on to more pleasant things really, John. You're in a show. You're acting in one.  John Wood: I am working, yes.  James Valentine: You are working, which is excellent. It's a new David Williamson play. It is. Now from memory, David Williamson, I think he's retired more times than Melba, hasn't he?  John Wood: Well not yet, but the last play I did of David's was his last play.  James Valentine: Right.  John Wood: Yes, I did that in 2020. We were closed down in our last couple of weeks by COVID.  James Valentine: Ah, right, right.  John Wood: And then, I got on a plane and went home with a whole lot of people. Gladys had let off the…  James Valentine: Oh, the ruby princess!  John Wood: The ruby princess.  James Valentine: Oh so you probably brought it into Melbourne. You're probably patient zero for Melbourne.  John Wood: Well, I could well be. James Valentine: So, some, you know, two, what now, four years later, three or four years later, he's back with another play. I mean, I don't want him to stop, but he keeps telling us he is. And so, it's a new play called The Great Divide.  John Wood: Yes, and it's an interesting piece and it's getting better and better all the time. The best writing in it, for my money, is the scenes between the younger women, who's a mid thirties mum and a seventeen year old daughter. And the writing for those scenes, it's terrific, you know, like the relationship's wonderful and the girls are terrific.  James Valentine: Tell me a little bit about that rehearsal process. It's interesting you say it's getting better. I suppose in most of our minds we think, you know, David Williamson's there at the desk, he completes the script and then, there you go fellas, just say what I just wrote.  And I think this is another thing to realize with Australian plays, isn't it, is that we often see them very fresh. Whereas the thing from overseas, we might have, it might have been through a lot of rehearsal, a lot of different productions.  So, you know, this, you'll have a chance to see something here that's absolutely brand new.  John Wood: Yeah, we had a session yesterday afternoon at four o'clock where a group of people from the ensemble audience that pay money to come and watch the director at work. And so we've already, yesterday, been in front of a small audience of about 20. And we had a quick Q& A afterwards. And you know, it certainly worked for them. But there was one lady there who wanted to ask me about a line that I'd done in Crunch Time.  James Valentine: Right.  John Wood: And, you know, I spend the whole play trying to get one of my family to give me the lethal injection. James Valentine: Right.  John Wood: And I had forgotten all about this, but I have a line which says, Oh, if you want anything done, you've got to do it yourself. And this woman had picked up on that and she had a copy of the text and it wasn't in the text. And I have no recollection of myself and Mark Kilmurray discussing putting, putting that line in. James Valentine: Right. It must have popped in there, at some point. How physically, how do you find it when it's, you know, six shows a week, eight shows a week, you know, we'd been talking about your arthritis and these sort of things. That's a big physical demand; you'll be in the season soon enough, and you're a veteran of doing this. Physically, how do you find it now?  John Wood: I don't think I have any major problems with it. You know, the arthritis is mainly under control, unless this elbow thing that Rod told us is probably arthritis.  James Valentine: Yeah, sorry about that.  John Wood: But I don't, you know, like I've been managing to stay working for most of the time, you know, when Blue Heelers came to an end, I was massively disappointed, you know, because it had been 12 years of just having to drive into the city and do the show and be on a pretty good wage and…  James Valentine: That's enough of that, young fella. John Wood: Yeah, ‘Doyle, my office'. And you know, like to suddenly lose that income was shocking. But I've been working in the theatre pretty much all my career. You know, when I was doing Blue Heelers, I was also doing Williamson's play, The Club, all over the country.  James Valentine: Great play.  John Wood: And, yeah, it's the funniest play ever written in Australia, in my view. It is just hysterically funny.  James Valentine: But that's good if you don't find the season taxing. John Wood: I can't imagine what I would do if I stopped acting.  James Valentine: Well, that's, I think you're a great advertisement for, you love it. So why stop doing it? You know.  John Wood: Well yeah, I can't, I can't imagine what I would do. It'd be nice if there was more financial reward involved in the industry, but I mean, we were left high and dry by ScoMo and his government during COVID, you know, like, shocking. I mean, you know, like his attitude to the arts and music I think was appalling.  James Valentine: John, you know, you said that you did, it started in your ankles, perhaps 15 years ago. If you think back to sort of you know, in your 30s to your 50s, perhaps when you're doing Blue Heelers, no signs of anything, anything that you perhaps should have dealt with. John Wood: I was going to a chiropractor. I, you know, I went to chiropractors for years, and I have since had a partial discectomy, you know, where they just cut a little, slipped down your spine and cut off the excess disc and that was fine, and I'm very careful with the way I use my back now. I've stopped using it as a crane, and, so that was the first year of Blue Heelers, so that was 1994, and the worst thing about that was I was supposed to go to the UK with Lisa to do publicity and I went into hospital to have the operation. And I kept looking out the window thinking, not very far away from here the crew and the cast are having a wrap party, and I'm missing it.  James Valentine: Well, it's fabulous to get some time with you, and I know we're going to see you on stages and screen, you know, for many years to come.  I hope so.  Despite everything spreading to your elbows and everywhere else. Um, but, Rod, thanks so much for everything you've offered. Absolutely fantastic.  Rod Grof: My pleasure. It's been fun.  James Valentine: We'll see you again.  Rod Grof: Thank you very much.  James Valentine: John. Thanks so much for being on the program. Great to catch up with you. And as we say, be talking about it's in the great divide by David Williamson. It's on at the Ensemble Theatre in Sydney until the 27th of April. I'd like to say, you know, break a leg, but I don't think that's probably good advice at this point.  John Wood: Oh, it's a pleasure to be here. Thanks, James. It's lovely to see you. James Valentine: Thanks so much to Rod Grof as well from Platinum Physio in Melbourne. You've been listening to Season 5 of Life's Booming. Is This Normal? Brought to you by Australian Seniors.See omnystudio.com/listener for privacy information.

Linked to metabolism and even menopause, weight gain for many over 50s seems inevitable, but is it really? We ask celebrity GP Dr Brad McKay for his take, and speak to author Jacqui Hodder about how she overcame an expanding waistline to embark on a trip of a lifetime.  About the episode - brought to you by Australian Seniors.  Join James Valentine as he explores the incredible stories of Aussie characters, from the adventurous to the love-struck. Across 30 inspirational episodes, Life's Booming explores life, health, love, travel, and everything in between. Our bodies surprise us in ways we never thought possible as we age, so in series five of the Life's Booming podcast – Is This Normal? – we're settling in for honest chats with famous guests and noted experts about the ways our bodies behave as they age, discussing the issues and awkward questions you may be too embarrassed to ask yourself. Jacqui Hodder is a Melbourne-based writer and teacher who embarked on a once-in-a-lifetime trip to track turtles in Costa Rica, documenting her journey in Turtling in Tortuguero. Overweight and prediabetic, she underwent a health and fitness overhaul to help her prepare, and keep up, on the month-long adventure.  Sydney-based GP Dr Brad McKay is an experienced TV and radio broadcaster, podcaster, columnist and author of Fake Medicine. He appears regularly on The Today Show, The Drum, ABC Radio, triple j, Triple M, has presented Catalyst on the ABC and hosts several medical podcasts for health professionals. He's also on the editorial board of The Medical Republic. If you have any thoughts or questions and want to share your story to Life's Booming, send us a voice note - lifesbooming@seniors.com.au Watch Life's Booming on Youtube Listen to Life's Booming on Apple Podcasts Listen to Life's Booming on Spotify Listen to Life's Booming on Google Podcasts For more information visit seniors.com.au/podcast. Produced by Medium Rare Content Agency, with Ampel Sonic Experience Agency Transcript:  James Valentine: Hello and welcome to Life's Booming series five of this most excellent and award-winning podcast. I'm James Valentine and in this series, we're going to ask the question, Is This Normal? I mean as we age stuff happens to us, our bodies change, things fall off, we get crook, stuff doesn't work as well as it used to. There's nothing we can do about it, we're getting older, we're ageing. But which bits are normal? Which bits do we have no control over? Which bits can we do something about? That's the kind of questions that we're going to be asking in this series, Is This Normal? of Life's Booming. Now, of course, if you enjoy this series, leave us a review, tell all your families and friends about it. And we want to hear from you as well. You can contribute to this. If you've got questions about things in particular that you want to know, perhaps there's some particular wear and tear happening to you. Let us know. We'd love to see if we can answer that question in the series. We're gonna look at things like menopause, gut health, mental health, lots of other burning questions. So, think about those areas and if there's something in there that's specific to you that you'd like us to cover, let us know. And now, on to this episode of Life's Booming, Middle age spread.  Weight gain weighs you down. Both literally, it's gonna weigh you down, slow your body down, and also mentally. You don't feel as good, you're sluggish. You probably don't like the way you look. Whether it's sitting there around your gut, or it's sitting there on your bottom, or it's making your legs fat, or wherever it's gathering. The gaining of weight is something that we all have to face as we get older. And it's not, often not pretty. And not really what we're hoping for. So, how do you lose weight? What do you have to do? Do you have to go off to the 6am bootcamp? Do you have to just eat beans for the rest of your life? What are you going to have to do about it? We've got two good people to talk to about this today. A regular on Australian television programs such as Today and The Project. Kiwi born, now Sydney based GP Dr Brad McKay is going to answer some of these questions and bring his medical knowledge and experience to this. But we've also got someone who's going to tell their story, and it's a very powerful tale. A few years ago, Melbourne author and teacher, Jacqui Hodder, was planning to go on a life changing trip. She wanted to head to Costa Rica, and she wanted to volunteer to help the turtle population there, to survive and to deal with all the threats that are happening to all the wildlife around the world. This was going to take a month. She was going to go there for a month. But it was going to be a physically demanding trip. So, she realised she was going to have to get fit and deal with this. But she'd also just had some big health news as well. It's a great story and inspiring.  James Valentine: Hello, Jacqui.  Jacqui: Hi, James. How are you? James Valentine: Yeah, good, good. Now, what do you usually do? What kind of work do you do? Jacqui: I'm a high school teacher. I teach English and I teach vocational education. And I also look after the careers in the school.  James Valentine: Okay. Oh, you're the career counsellor. Jacqui: I'm the career counsellor. That's right.  James Valentine: Okay, so we come to you, and you tell us, look, you really should be a physiotherapist and then we turn out to be astrophysicists, is that it? Jacqui: Well, the theory is these days, five different careers, not jobs, but careers in your lifetime.  James Valentine: Well, that's kind of you. You've got whole other careers as well, right? Jacqui: Absolutely. Yes. Done many different things over the years, for sure.  James Valentine: And tell me, you write as well.  Jacqui: I do. Yes. I've always wanted to write. I've written a little book about this journey, but also written some short stories and things like that as well. So yes, quite a lovely passion of mine for sure.  James Valentine: And it was, it was part of a writing project that led you to have to deal with some health issues.  Jacqui: Um, the way it came about, if you're happy for me to go on with the story, I was teaching a year nine civics education class, and we had a guest speaker come in who'd been to Costa Rica, and she had worked with a jaguar project in the jungles of Costa Rica, and she was putting all these images up on the board of armadillos and toucans and turtles that she'd worked with. This was at the end of the first year in lockdown in Melbourne, and it was via zoom. And I think something just spoke to me. I think that want for adventure, that, that exciting allure of something different than my house and being somewhere else really grabbed me. It just spoke to me. I thought that's really what I want to do. But obviously because we're on this program, I was quite overweight. I had some health issues. So the first challenge was, would I be able to do it? I had to be able to, according to the program I wanted to go and volunteer with, I had to be able to walk four to five hours on soft sand every night in the tropical humidity, plus, work with the turtles as well at night. So it was quite a physical program I was setting myself up for. So, I just turned 60, this was the beginning of January 2022, and I wanted to go for long service leave in the September. And so I set myself a goal of trying to get fit, fit enough to be able to walk those distances for that length of time. I had to also be able to walk eight to 12 kilometres on the soft sand as well, that was what the guidelines were. So I started off, and I remember my first session was down near where I live, walking down to the beach, along the beach, and then back up this set of stairs and panting quite remarkably as I got to the top, not sure if I'd make it. And that was the beginning.  James Valentine: It sounds like a big aim to me. It's like you've gone from sort of zero to a hundred. You're sort of, you're not going, ‘might just walk around the block'. It's like, I need to be able to rescue wildlife in Costa Rica. It sounds big. Jacqui: Exactly. Right. I just, I don't know. I don't know if you have those moments in your life where things just speak to you. And I was just like, I want to do this. That's something that was very clear in my mind, but I knew I had to get to a certain level of fitness to be able to do it, and I was quite overweight. I was probably about, probably reaching almost 100 kilos and I'm quite a small person. I was five, I'm five foot two and a half. Not was, but I am. So it was quite a challenge. Yes. So, I started with the fitness. I just knew I had that goal of making that distance for that length of time on the soft sand. That was the kind of significant part.  James Valentine: And nothing else up until then, nothing else had prompted you to want to lose weight, right?  Jacqui: Not quite true. I mean, I've been overweight. I've struggled with weight my whole life and I have tried various diets and I've lost weight, but it's always crept back on and that's the significant part for me. How do I keep it off? So, I knew I could lose weight if I really put my mind to it. At that stage, the goal wasn't so much to lose weight. It was to get fit enough to do the program. But when it got closer, I started to worry about keeping up with the young people because I knew there'd be young people on this experience. I knew I was going to be someone who, you know, was the oldest probably. So, I wanted to be able to keep up with the young people at night.  James Valentine: Don't we all? Jacqui: So, I got to April. And I was on holiday, and I was standing up from taking a photo of this family on the beach and I felt something go twang and it was my intercostals. So, I went to the physio and the physio said, she just laid it out for me, which was actually great for me. I didn't know I'd be able to take it so well. She said, Jacqui, you're going to have to go to the gym three to four times a week and do weight training and resistance for the rest of your life.  James Valentine: Wow.  Jacqui: Okay. That's what I need to do, super clear. So, I started going to the gym as well as walking. I still really wasn't losing the weight. James Valentine: Let's go back to, also just go back to that sort of first walk, you know, we left you, you were sort of panting up the stairs back to your house, right? So, that was in that first walk, did you also go, oh, I've got a long way to go?   Jacqui: I've got a long way to go, but I knew if I could dedicate a regular routine to walking, I knew I'd be able to get, it was the distance I was worried about and the time.  I couldn't ever quite make three and a half hours totally on the soft sand and I had to be able to do four to five hours.  James Valentine: Wow. Jacqui: It's really hard walking on soft sand. In fact, when I came back, I swore I'd never walk on a beach ever again.  James Valentine: I don't like having to get back to my towel, quite frankly. So, you know, to do five hours just sounds impossible.  Jacqui: And as it turns out, it was probably overkill, but I can explain that. A little bit later.  James Valentine: Yeah, right.  Jacqui: But yes, I was gradually building up. So, I was going pretty much Mondays after school, I was going Wednesdays, Fridays and on the weekend I'd try and do a long walk, walk on the weekend as well. James Valentine: And you were maintaining that, so that discipline was staying with you, you can see the aim, you can see the turtles on the beach, you can see where you're going.  Jacqui: The motivation was so clear. And that's partly also the challenge because when I came back, I knew the trick would be how to maintain that weight because I wouldn't have that clear motivation anymore. So yes, going to the gym and walking, my routine was getting quite busy at this point because I was going three times.   James Valentine: How many months out from the trip did the intercostals go?   Jacqui: That was April, and I was going in September.  James Valentine: Yeah. So, during that period you then start to do what, do daily gym routine you were saying, daily gym weight routine and walking. Jacqui: I was going to the gym three to four times, so Monday, Wednesday, Friday, Saturday, and then walking as much as I could on those days, but also the in between days as well. But obviously I'm working full time. So, the long walks I could really only do on the weekend.   James Valentine: So, what was happening to your weight? Jacqui: The weight, actually, to be honest, wasn't really changing. I was feeling like I wasn't panting up the stairs anymore. So, I could tell I was getting fitter, but I wasn't actually losing weight. So, when it got to June, I thought, I actually need to take an extra step here, because again, I guess I would be a little bit embarrassed. If I was going to be going to Costa Rica and working with young people, and there I was a very overweight, older person. So in June, I went on a program that I've been on before I knew it worked, which is the CSIRO Wellbeing, Total Wellbeing Diet. And I actually picked up a new book, which is the low carb one, because actually that was the other thing I hadn't mentioned was I had been diagnosed as pre diabetes in April as well.  I've also been on high blood pressure medication and high cholesterol medication for a long time as well.  James Valentine: Right. You've got it all going on at this point. So, you've got to deal with pre diabetes, you've got the intercostals have gone, you've got to get to the gym, you're trying to lose the weight. Jacqui: Yeah.  James Valentine: This is a lot to encompass, isn't it? Prediabetes, what does that suggest is going on?  Jacqui: High blood sugar, so basically, it's a precursor to type 2 diabetes, which is a very serious health issue, as you know.  James Valentine: But at that point it can be dealt with, with diet, right?  Jacqui: It can be, yes. And the doctor was very good. He explained everything to me of what I could do to change my lifestyle, which I was happy to say I've tried, I've already started doing. I've already started the walking, not to lose the weight. I don't think I've ever found, like in terms of the psychological part of losing weight, the kind of fear of health issues has never, unfortunately, been a motivation for me. I'm not sure why, but the motivation to work with turtles was working.  James Valentine: Isn't it funny what it'll take to get us to do some stuff? So by April, May, June, you're at the gym. You're dealing with the diet, you're trying to lose the weight. You're walking, you're slogging yourself through the sand. It's a, it's a brutal routine you've really got onto. What the CSIRO diet, just tell us a little bit more about that. I mean, part of my general understanding is in some ways it's quite straightforward. It's a sort of, you know, meat and salad and you'll be good.  Jacqui: Well, the low carb one actually does, they're not so meat focused because originally that was kind of what we knew about the diet was how much meat or protein was involved.  But the low carb one substitutes a lot of nuts and fish and not much bread or pasta or obviously the carbs. And what I love about the Total Wellbeing Diet, I think, is they have a 12-week program and it really clearly outlines what you need to eat at breakfast and the quantities, lunch, dinner, and it has recipes in there, and it's 12 weeks. And 12 weeks feels manageable. It's a chunked-up amount of time. So, I knew if I could go on the 12-week diet, well, I hoped I'd be able to lose the weight because I had before being on that diet and I succeeded. I lost probably about half of what I've totally lost by the time I was in Costa Rica, so it did work. James Valentine: Okay. Okay. Well, we might leave a cliff-hanger there and we'll, you know, be able to build towards what happened in Costa Rica. Did the turtles attack? We'll get to that part of the story. But I might bring in our very helpful doctor here, Dr. Brad McKay is with us. Hello.  Brad: Hello. Hopefully I can be helpful.  James Valentine: Yes. Excellent. Well, what kind of things are you hearing in that story? I mean, one of the things that struck me is, the exercise wasn't working. We all think we'll be able to burn that fat off. Not necessarily.  Brad: Yeah, it's, it's a very common presentation. So, very commonly, people like Jacqui will be wanting to lose the weight, they'll increase their exercise, they'll change their diet, and the evidence sort of shows that you might be able to lose about two percent of your body weight doing that. If you're really giving it a red-hot go, you might be able to get to five percent of your body weight being lowered, but it's really, really hard to push past that. And if you stop doing what you're doing, so if you stop starving yourself, then you tend to go back to that pre-existing weight. Your body loves to sabotage you and it loves to get back to your highest weight that you've ever been.  James Valentine: Right. So why, I mean, we see all those lean swimmers and football players and they run around all the time and they, you know, they eat a good diet to try and be great athletes. Why are they so skinny and I'm so fat? Brad: Well, they may be younger than you, so that's one thing. But also often those athletes haven't been overweight before. They haven't gone into an obese category, so they've maintained their weight.  Their body isn't trying to sabotage them. It's not trying to get to that heavier weight because they haven't been at that weight before.  James Valentine: Right. And so this has a lot to do with ageing, does it? When we get to a certain age, the weight is going to stay there? Brad: Yeah, so as time goes on, then we generally sort of like waver, we go up and down with our weight, and so every time you're in that flux of change, your body's trying to get to that highest level. So, just with a graph, if you're looking along this wavering line, it just slowly tends up all the time, because that's what your body is trying to do, it's trying to store energy. Evolutionarily, we have designed, our body has sort of evolved to be like that.  James Valentine: So, we're always, so as we age, we always, our body wants to put on more weight. Brad: So, our body wants to store energy to keep us alive for longer in case we can't kill that Saber-toothed tiger next week. We've got to have that energy on board.  But when we have lots of food around, when we have fast food, when fast food is cheap, when we're not exercising as much, if we're not racing around, and competing in Olympic sports, then yeah, we tend to put on that weight. And so that's a very common story.  James Valentine: And so, does that just keep on going? At 50 it'll be X and at 60 it's X and a half? Is it that sort of thing?  Brad: So it's not guaranteed. So, a lot of people do increase their weight and they're able to maintain, increase their exercise and they're able to maintain their weight at that level. Some people get really sick, and they lose lots of weight as well. There's also metabolic factors. There are hormone factors involved too. So, there's lots of variation. It's not inevitable.  James Valentine: So, when Jackie was just exercising, that wasn't doing it. What's the difference when you add diet? Brad: Well, if you're exercising to improve your health, you need to be exercising for about 150 minutes per week. And that's getting to a really high level where you're feeling puffed, where you may be able to have a brief conversation with somebody, but you're not able to sing. That's a great description in medicine for that. James Valentine: But I can't sing anyways.  Brad: You're screwed, yeah. So, the other part of it is if you're wanting to then lose further weight, then you need to be doing about 300 minutes every week at that level.  James Valentine: Right.  Brad: So, if you're wanting to then gain that further, then you've got to be really strict with your diet as well, and certainly a lot of the evidence does just look at the energy in versus energy out. So yeah, if you're not exercising and not using up that energy, then your body is going to store it somewhere.  James Valentine: Right. And so by diet, do we just mean eat less?  Brad: That's also the type of food that you're eating as well. So, if you're eating lots of saturated fats, lots of fat, meaty products, if you're eating lots of white bread and carbohydrates, then yeah, like you're going to be, yeah, maintaining that and your body is going to love that and want to hold on to it. James Valentine: Oh, so different foods are held onto more resolutely by the body.  Brad: There's a lot more energy that's in certain foods compared to others. So, for example, if you're eating lots of vegetables, then you can feel full, if your stomach is full of beans, for example. But you've also got lots of fiber. It takes a long time for your body to digest that fiber. So, you'll have a little bit more energy for longer, rather than just bread that dissolves in your hands. before you're even able to put it in your mouth. So, your whole gut is sort of activated and it takes energy as well to break down that food too. So, the more rough your food is, the more whole greens you have, the more nuts you have, then yeah, it takes longer for your body to break it down. And also, it's not packed full of sugar, which is easily getting into your bloodstream and spreading around.  James Valentine: Now Jacqui, were you, did you know this sort of stuff when you went onto the CSIRO diet? Did you learn it as you went through?  Jacqui: Yeah, the thing about always struggling with my weight is I tried many, many different diets. Kind of know the facts and figures. I'm not sure I knew exactly why there were so many nuts in this particular diet, but it makes sense hearing what Brad's talking about for sure.  James Valentine: What are the things that struck you about the CSIRO diet? What was different?  Jacqui: I like the structure and I really like how each week is, like, it's a 12-week program and each day is pretty much designed for you in terms of quantities, in terms of what you need to eat, in terms of recipes.  So, I find that in a busy life, very straightforward to follow. The trick is what you do afterwards. Once it finishes.  James Valentine: What do you mean by that? Oh, once it finishes. Yeah. So, you mean after the 12 weeks, it doesn't say week 13 Mars Bar?  Jacqui: Well, I actually, I've got some little tips that have helped me, but one of them I think is for me having a day off every week. I hope that's not too naughty, but you know, just because I mean, it's very hard to stick to the same thing day in, day out. So, I give myself like a little treat one day a week where I just think I am going to have some hot chips for lunch, or I'm going to have pizza for dinner or something like that. And then I go back onto it again the next day.  James Valentine: Yeah. What do you think, Brad? Brad: Yeah. So, Jacqui's exactly right. So, what you're wanting isn't just a 12-week program. You're wanting to be able to follow that eating habit for the longer term. And so often you do need a day off because if you don't, you will just fall over at the end of that 12 weeks. You'll go back to your previous eating habits. So yeah, I think it's crafty and it's helpful to do what Jacqui's been talking about. So having those days off and being okay with you, giving yourself a break, giving yourself a bit of leniency. Because you're needing that, to do that in the longer term.  James Valentine: Why don't most diets work? I mean diets usually fail, don't they?   Brad: A lot of diets fail. A lot of people are going along this whole dietary cycle where they are trying everything under the sun. And not one diet works for everyone. Everyone has different metabolisms. So, what may work for Jacqui may not work for you. So yeah, you will have lots of Instagram influences and people online telling you that their green smoothie is going to be helpful for you losing weight.  James Valentine: But it's also, diets will often be around a fad, which will be, you know, one particular food, or one particular activity, or one particular way of thinking. Now again, that's hard to maintain, isn't it?  Brad: Yeah, if you're on a grapefruit diet, then you're probably not going to be doing that forever. James Valentine: Yeah, yeah. What's different about the CSIRO one?  Brad: So, it's a bit more about healthy eating, and having healthy habits, and being able to continue it in the longer term. Also, the variety is really important because you're needing to not get bored by that grapefruit that you're having every day. You're needing that variety, that spice of life.  James Valentine: Yeah. The other thing I was struck by Jacqui, and let's, I asked you this sort of a little earlier, but you know, let's talk about it a little bit more. The motivation was, is so curious in a way, it is quite an extreme thing that it's like you suddenly went, I wouldn't mind white water rafting, you know, kayaking or something. It's like you took quite a big step. It took a motivation that was a big step out of your normal life. Why had motivation failed before? What, what, why doesn't the motivation of just, I want to lose weight, I know that's important. Why isn't that enough?  Jacqui: It's interesting, isn't it? I mean, if I knew the answer, maybe I wouldn't have waited till I was 60 to finally lose some weight. And also, I do feel it's a very fragile truce I have at the moment. I feel like I have to trick myself. I have to check. So little tricks I have is to check what's for breakfast the next day in the program, the night, the day before, just so that I can, every day I'm making that decision. Today I'm going to follow it. If I don't, I can fall back into old habits, but Brad, I had the doctor say to me it can take two years for the body to stop wanting to sabotage yourself. And so that really helped me as well because I thought, okay, if I can get up to two years, I've still got to remain vigilant. I had a mantra, be vigilant because losing that weight was my last chance. I felt if I put the weight back on this time, I'd never take it back off again.  James Valentine: That's interesting, isn't it? Like that I wouldn't have really known that because I think most of us think I'll lose 10kg and then I'll be fine.  Brad: Yeah. I suppose the thing is there's no magic number as well. So, I'm not sure whether that doctor's coming up with two years for it is often like a longer term sort of like hunger and a drive for food. It's a very primitive reaction. There is some sort of changes. So, if you have been eating a lot and then you have been eating less, then your stomach will shrink a little bit over time. And so, if you're having food, your stomach will stretch earlier and so you'll feel fuller quicker. So that may be what they were talking about. But yeah, your body wants to sabotage you forever. Sorry, Jacqui. It wants to sabotage all of us.  James Valentine: But does your appetite sort of change? I mean, like I want pizza. I want chips. I want pies. I want cake. If you change it, does it just take a few years for you to start to, I want salad. I want tomatoes.  Brad: So, a lot of my patients will find that, yeah, if they're, if they're on a diet, if they change their diet, they will often continue to have this voice, this hunger, telling them to go to the fridge and telling them about the foods that their body is craving for. So and I think that that voice diminishes a little bit over time, but it's still going to be there.  James Valentine: Jacqui's superpower is she changed her whole appetite?  Jacqui: Well, gosh, like I said, it's quite, I know it's fragile. I know I can, I just went into the fridge the other night and had a little binge. Just the stress, you know, but I have to think, no, go back on it the next day, back on it the next day. James Valentine: Yeah, it's a beautiful description. You've used a fragile truce, isn't it? And I'm sure a lot of people with addiction would feel a similar sort of thing. And there'd be lots of aspects of our life where we have a fragile truce.  Jacqui: Yeah, I do feel like it's been a little bit of an addiction over the years, the eating, you know, it has been that thing I've used, I think, to comfort myself, not very healthily. So, yeah, I'm definitely, I've got that vigilant, be vigilant in my head for sure. That's what I do.  James Valentine: Yeah. And let's go back, Brad, to the motivation, the fact that this, you know, Jacqui conceived of this Everest, climbing Everest-type desire. That's powerful, isn't it?  Brad: Yeah. So, I suppose one thing that I'd be wanting to mention is that people can be motivated, they can be driven, and they have every aspiration of reaching their goals. And then often, they aren't able to do that. Their metabolism works against them, their hormones work against them, their body. works against them. And they will often feel like a failure. And I think this is just this horrible sort of occurrence that just permeates throughout the world. We often have a stigma towards obesity and people being overweight. And we often blame people for just putting things in their mouth. But it's not people's fault that they're gaining weight. And it's not their fault if they can't lose weight. There are just so many other factors involved with it. And we try to simplify this as people and our understanding of it. We try to put it in a box. And so, yeah, it's just a reminder that if Jacqui has got the motivation and drive and has some tools in her belt that she can use to get to that level, and she's happy with her weight and where things are at, that is amazing. That is fantastic. But yeah, some people aren't that lucky. They aren't that fortunate and there are, and it's not their fault if they can't reach it. James Valentine: Yeah. Did you feel those kinds of things that Brad was describing there, Jacqui? And, and I'm wondering, do you necessarily feel a victory or an elation now?  Jacqui: No, I mean, certainly sometimes when I put some clothes on and I am pleased, you know, that I'm thinner than I was, but one of the things I think, absolutely what Brad said.  My message would never be to shame someone. I never wanted like a before and after photo, for instance, because I've seen them all. I've seen those photos on TV or the magazines.  Brad: They just changed the lighting, Jacqui.  Jacqui: Because I've, you know, inverted commas here, but I feel like I've failed so many times because and that's, I guess, part of the fragile truce. Now, you know, I feel like I could, I don't know how to word it properly, but I suppose go backwards and, I never want anyone to feel that, you know, I've got it sorted because I'd be the last person to say that. If I had it sorted, I would have 40 years ago.  James Valentine: Yeah. Well, I almost wonder where there's a sort of like an almost reverse thing if you, if you're feeling great now and everyone's complimenting you now, it almost sort of, it doubles, the shame of the past.  Jacqui: Or the pressure to, to keep it off.  James Valentine: Or the pressure of it. Or sort of like, oh, so that's, it is, everybody is just sort of incredibly admiring of skinny. There is only skinny, you know, that sort of, that sort of thing is wrong too, isn't it?  Brad: It's a great way to force an eating disorder. James Valentine: Yeah. A great way to force an eating disorder. Let's consider age as a factor in here, Jacqui's done this at 60, which is pretty impressive, you know, I've barely got the motivation to do anything anymore, really. So the, is it, is it harder, is it physically harder to be losing weight, and I suppose a big factor of that will be a psychological thing. Mate, why am I bothering? This is me now. You know, come on, you know, let me enjoy myself. Really? What have I got to gain? You know.  Brad: I think it's, it's also mobility. And so over time we accumulate problems, we develop injuries. And so, it gets harder and harder to move. Our heart doesn't work as well as what it did when we were a teenager. So, we can't quite get to that level of exercise, yeah, that endurance, that ability to go all of the yards that we're needing to, to exercise enough to bring down our weight.  James Valentine: But we can do diet.  Brad: We can do diet. But again, it can be very, very restrictive.  James Valentine: Yeah. Do we talk about it incorrectly, really? We should be talking about how hard it is, not, we've got this easy one fix. Try this diet. Come to my bootcamp. We'll be able to, able to fix everything.  Brad: I think in medicine we are trying to change that narrative for decades. So, trying to talk about like healthy eating habits and, yeah.  Trying to teach teenagers, uh, which foods to eat so they won't end up overweight or obese over their, over their life. So, I think our way of changing with television, with the media, and trying not to stigmatise people for their weight as well. This is sort of like a weird conversation that's going on right at the moment.  Not fat shaming people, and people are talking about like being fat fit where they may be overweight, but they're actually like healthier than what I am at the moment.They can run a marathon. I couldn't do that at the moment.  James Valentine: Yeah. It's worth underlying that, isn't it? Because that's a reasonably recent change. We've gone from a sort of sense that we've got to point out to these fat people that they need to lose that weight because it's no good for them. You know, your heart's struggling, you'll get diabetes. We've changed, we've changed, that attitude's changed considerably. Brad: I think it's a real interesting time at the moment. We've gone from fat shaming to now being like fat fit and body positive. And now with the introductions of a range of different medications that are all coming around the world, which are enabling people to lose more than that five percent that they could do under their own steam, getting down to 10, 15%. Some of the medications that are coming around the corner could get even up to 25% loss of your body mass. This is sort of like disconnecting people's relationship with food. It's allowing them to change their body type. And I'm really sort of intrigued to see what happens with the social discourse and social understanding of that as we've gone from body acceptance, and this is how it is, to oh well, they're a skinny bitch because they've been using this drug. James Valentine: Yeah. Are you supportive of the Ozempic Revolution? I guess it's one of the brands that people might be more aware of than others.  Does that seem like a good thing to you?  Brad: Overwhelmingly, it's positive. So having one injection a week is suitable for a lot of people. But it's not just about the weight loss. Like, some people look better and that's what they're going for, fine. But if you're losing like 10 percent of your body mass, then it's going to decrease your risk of high blood pressure, decrease your risk of diabetes, decrease your risk of heart attacks, other heart disease. Decrease strokes, also decreases your risk of getting a whole bunch of cancers that are related to obesity and being overweight too. So, it's overwhelmingly, this is, yeah, a good, a good thing around the world.  James Valentine: Yeah. Jacqui, if that sort of thing had been available through the years or now, do you subscribe to that? Would you be happy with that?  Jacqui: Very tricky. I'm not, I'm not actually sure. I mean, I was so reluctant to go on medication of any kind. I always wanted to try, if I was going to lose weight to try and do it, I suppose, inverted commas again, naturally. Because I, but I mean, Brad's absolutely right. I mean, I don't know everyone's metabolism, like everyone struggles in their own way with these things.  But certainly in terms of what Brad was saying, I think for me, I was so pleased to come back from Costa Rica and the doctor ran the blood tests again and I was not prediabetic anymore. So certainly, in terms of losing weight, it certainly helped my health prognosis, I would say. My heart blood pressure, high blood pressure medication went down by half as well. I'm still on those tablets just because we have a history of family heart disease, heart disease in the family. But, in terms of losing weight, it did actually have some health benefits, absolutely.  James Valentine: Well, when we left Jacqui, she was about to embark on a flight to Costa Rica to save the turtle population of the beach there. Jacqui, pick us up with the adventure. What happened? What happened when you got there? Could you do the walk?  Jacqui: So, yes, for all their kind of, you know, you need to be able to walk four to five hours every night, 10 to 12 kilometres on soft sand on the black beaches of Costa Rica on the Caribbean coast.  Yeah, we didn't actually go out every single night, so I could get some rest time in between. And most of the nights, we would walk for a while, for sure, there was a lot of walking, but then we'd stop and work a turtle, which means we'd get in the pit with the turtle, we'd measure it, we'd body check it, we'd go under the turtles to catch the eggs and count them.  So, the physicality was the walking, but also getting in the nest with this very big base, trying not to get sand flipped everywhere by their very strong flippers. James Valentine: So, you were the Steve Irwin of turtles at this point. You're Crikey! Look at this, look at this fella. Describe the turtles. What species are they and what do they look like? Jacqui: So, this is the second largest in the world, Australia has the largest, but, largest in the Western Hemisphere of endangered green sea turtles. This is their nesting beach, so peak season they were coming up onto the beach and laying their eggs. They're quite fascinating creatures.  James Valentine: And how many, like in the thousands? Jacqui: Oh yes, could be in a whole season, even tens of thousands, yes. But obviously they have their perils, I mean they are endangered, and human predation has a lot to do with that.  James Valentine: And so, is that what the task was, was mainly to protect them from things like that or?  Jacqui: So, it's collecting data for Sea Turtle Conservancy in Costa Rica. That was the organization I went with.  James Valentine: And did you turn out to be, was it a bunch of sort of slim young gap-year type people who were running around doing this and you?  Jacqui: Yes, yeah. But there was one lady who, accidentally, I didn't know, and it was just random that she was there at the same time who was about my age. So, I was very fortunate how that worked out, but the young people were wonderful. They took me under their wing, and they made me feel like I was their mama for sure. They were lovely.  James Valentine: And as like you were so motivated to go and do this, this obviously turned into sort of like, this is a journey that I really want to make. This is my dream sort of adventure to go and do this.  Jacqui: It was life changing in so many ways. I think just, I mean, the young people were so inspiring, their love of conservation, their love of nature, the willingness to kind of be involved in something like that for months at a time. But obviously in terms of my weight and my fitness and my breadth of understanding about the world, I never, didn't even really know where Costa Rica was before I went. James Valentine: What's next? Because having conquered that, it sort of feels like, well, what can I take on now?  Jacqui: Well, yes, that's right. We did spend a little bit of time in Spain and discovered hill walking, which is very good for the fitness as well. And then, hopefully maybe India at the end of this year, but we'll see how we go. James Valentine: Fantastic. Brad, I'm inspired. You know, like I sort of feel a little bit ashamed. I sort of think, oh, I wouldn't mind a house down the South coast for a while. That could be good.  Brad: Are you training for cheetah conservation?  James Valentine: Yeah, cheetah conservation. You need to chase down a cheetah and just inject it for a moment. James Valentine: Just measure its fore paw and then, you know.  Brad: Work it up. Count its eggs.  James Valentine: Yeah. Have you got anything like that? Or do you have a sort of dream journey or something like that that you'd love to do? Brad: I'm a bit of a veteran at Burning Man, so I often, yeah, like, pack up my stuff and then go into the middle of the desert and try to make sure that I'm fit enough to survive in Nevada with very little resources. James Valentine: Were you there for the big muddy one this year?  Brad: I was trapped in the mud.  James Valentine: Really?  Brad: For quite a few days, yes. James Valentine: Oh, that's a very good annual adventure. And I think your weight might be a little crucial there too.  Brad: You lose a few kilograms, yeah. When you're struggling through, through muddy sand. James Valentine: Well look, fantastic. Great conversation. Thank you so much for, you know, Jacqui, thank you so much for sharing so much there. That's a very personal story that you've revealed for us. And thank you so much.  Jacqui: Thank you very much indeed, for the honour.  James Valentine: Brad, thanks for your expertise. Brad: Thanks for having me. James Valentine: For more about Jacqui Hodder and her weight loss journey, you can read her book. It's called Turtling in Tortuguero. And Dr Brad McKay's got a book out as well, it's called Fake Medicine. You'll see the links in the show notes, you'll find them in bookstores and libraries right now. I think you'll agree, great story from Jackie and terrific information from Brad.  You've been listening to Life's Booming, Is This Normal? Please leave a review or tell somebody all about the show. If you want to know more, head to seniors. com.au/podcast. You'll get our earlier series there and more episodes. I'm James Valentine. I'll see you next time for another Life's Booming.    Tortuguero! Turtling in Tortuguerro! I love just dropping into accent for one word, it's always very powerful. Okay.See omnystudio.com/listener for privacy information.

Join James Valentine as he explores the incredible stories of Aussie characters, from the adventurous to the love-struck. Across 30 inspirational episodes, Life's Booming explores life, health, love, travel, and everything in between. Our bodies surprise us in ways we never thought possible as we age, so in series five of the Life's Booming podcast – Is This Normal? – we're settling in for honest chats with famous guests and noted experts about the ways our bodies behave as they age, discussing the issues and awkward questions you may be too embarrassed to ask yourself. If you' have any thoughts or questions and want to share your story to Life's Booming, send us a voice note - lifesbooming@seniors.com.au Watch Life's Booming on Youtube Listen to Life's Booming on Apple Podcasts Listen to Life's Booming on Spotify Listen to Life's Booming on Google Podcasts For more information visit seniors.com.au/podcast. About Australian Seniors Produced by Medium Rare Content Agency, in conjunction with Ampel Sonic Experience AgencySee omnystudio.com/listener for privacy information.

After receiving a life-changing cancer diagnosis, award-winning surf writer, husband and father-of-two Tim Baker turned his attention to making peace with his mortality and living in the 'now'. If you' have any thoughts or questions and want to share your story to Life's Booming, send us a voice note - click here Watch Life's Booming on Youtube  Listen to Life's Booming on Apple Podcasts  Listen to Life's Booming on Spotify:  Listen to Life's Booming on Google Podcasts  For more information visit seniors.com.au/podcast. Produced by Medium Rare Content AgencySee omnystudio.com/listener for privacy information.

How does anyone get drawn into a cult and how, when the extreme beliefs that have ruled their lives prove baseless, do they recover? Tune in as David Ayliffe shares the lessons from his own experience.See omnystudio.com/listener for privacy information.

When Rosemary Kariuki fled her home in Kenya, she arrived in Australia without support and struggled to understand her new culture. But the charismatic Local Hero soon found a way to connect with her community.See omnystudio.com/listener for privacy information.

When Todd Russell and Brant Webb were rescued after two weeks trapped in a Beaconsfield mine in 2006, it was seen as one of Australia's greatest survival stories. But for Todd, that was only the start of his battle for survival.See omnystudio.com/listener for privacy information.

In the face of her worst nightmare, Bridget Sakr continues to draw on her faith to turn aside anger and instead focus on love and forgiveness to help deal with the trauma.See omnystudio.com/listener for privacy information.

More than eight years ago Rosie Batty suffered an unimaginable loss, following the horrific murder of her son Luke at the hands of his father. In the midst of her grief Rosie was catapulted into the spotlight, as she channeled her tragedy into a power for reform around family violence.See omnystudio.com/listener for privacy information.

This six-episode series tells the incredible stories of over 50s who have survived some of the most extreme challenges life has thrown at them. Listen in and discover their tales of outstanding fortitude.See omnystudio.com/listener for privacy information.

Christine Henry thought she was ready to get married, settle down and have kids. But as she was on the way to shop for an engagement ring, something made her turn to her husband-to-be and ask him to stop and pull over. There was something else she needed to do. **This episode was recorded in December 2021**See omnystudio.com/listener for privacy information.

Everyone has a story - but if you passed them on the street you’d never guess how incredibly moving it might be. Dr Andrew Kwong, a GP on the Central Coast of New South Wales, spent his early life surviving the famine and persecution of Chairman Mao’s Great Leap Forward. It was a long road to escape, but he eventually made it to Australia. This is his story. See omnystudio.com/listener for privacy information.

Remember when you got all your information about the world from the Encyclopedia Britannica? For Graciela Szwarcberg and Hector Poch, a couple of paragraphs in that encyclopedia was all the information they had about Australia, before they moved to Sydney from Argentina in 1991 with their two young children. But that’s not where the adventures stopped. Once their children grew up, they headed off to Europe and bought a motor home. They’ve travelled through more than 30 countries together and are still on the move eight years later.See omnystudio.com/listener for privacy information.

Lloyd Godman began adult life as an apprentice electrician, but a one-way ticket to Hawaii with only a backpack and a surfboard to spend nine months living in a treehouse would change his trajectory forever. See omnystudio.com/listener for privacy information.

When you left school, did you know what you wanted to be when you grew up? A spur of the minute decision for Jenny Muldoon started her on a journey that would lead to some pretty extraordinary life experiences, including dinner with John Travolta. So what was it that she decided to do?See omnystudio.com/listener for privacy information.

Gill Shaddick was in her early 20s and living in Hong Kong, spending her spare time becoming an avid amateur sailor. One weekend on her way to compete in a sailing regatta, the yacht was hit by a storm - she and her teammates were captured by Chinese communists, becoming the subjects of a huge sea and air rescue operation.See omnystudio.com/listener for privacy information.

No Regrets is the latest season in the Life's Booming podcast hosted by James Valentine. It’s all about the incredible stories of Aussies who made a decision that changed their life forever. You’ll hear what it’s like to have dinner with John Travolta, escape Chairman Mao, what it takes to join the sisterhood, live in a treehouse, travel through more than 30 countries in a motorhome, as well as the terror - and unexpected hilarity - of being held hostage after your boat is lost in a storm and ends up in foreign waters. See omnystudio.com/listener for privacy information.

Blossom the possum, a non-dating website, and a whole lot of luck was responsible for bringing John and Noreen, both 64, together. But something is threatening to tear them apart.See omnystudio.com/listener for privacy information.

John was married with four children when he suspected he might be gay, but it wasn’t until he was in his 50s that he finally came out and told his wife and family. See omnystudio.com/listener for privacy information.

In this episode of Dare to Date you’ll hear five diverse stories and a good dose of excellent advice! From the funny to the downright emotional, The Dating Diaries has all bases covered. See omnystudio.com/listener for privacy information.

Online dating is not just for the young. Barry and Liz met on the phone dating app Tinder in their early 60s, and after saying they will never marry again – decide to tie the knot.See omnystudio.com/listener for privacy information.

Former teenage girlfriend and boyfriend Melissa and Paul, who started dating at school in Papua New Guinea, connect on social media and reignite their romance – 42 years after last seeing each other.See omnystudio.com/listener for privacy information.

A story of love, deception, and heartbreak as Michelle meets the man of her dreams – an airline pilot. But not all is as it seems, and alarm bells soon start ringing.See omnystudio.com/listener for privacy information.

Dare to Date is the latest season in the Life's Booming podcast hosted by James Valentine. It’s jam-packed full of real-life stories of sweethearts reuniting, online dating trials and triumphs, plus the fraudster who should be avoided at all costs! Stay tuned.See omnystudio.com/listener for privacy information.

Rockabilly dancers, rock’n’roll circuitgoers and avid Elvis fans Lyn and Peter Davis talk to James Valentine about life on the road with Wagz their dog in a refurbished 1986 bus that follows the music. From the friendships they’ve made to the range of towns across Australia they’ve visited. Don’t miss Lyn’s extensive Elvis memorabilia, which includes cushions, a thermometer, a jukebox, hand towels and salt and pepper shakers, plus James singing a few tunes of his own. This heartwarming episode will make you want to dance.See omnystudio.com/listener for privacy information.

Bob and Phyllis Bowers are adventure junkies. They’ve been married for 53 years and it’s their shared love of exploring that keeps them together, from kayaking to camping, hiking and abseiling. They’ve had near-death experiences down the Nymboida River, completed seven-day hikes in the Kimberley and seen the incredible Gwion Gwion Aboriginal rock art (formerly known as Bradshaw art). Their love of small towns across Australia and the wonderful people they’ve met along the way continues to inspire them and their trips. See omnystudio.com/listener for privacy information.

For the past three decades, Wendy French has joined her husband Graham on "holidays" around Australia, where they romantically park up beside disused railway lines and wait – sometimes for days - to see elusive trains. You read correctly... trains. This heartwarming episode is full of laughs and surprises, and a reminder that the things we do for love don't always make sense. All aboard for train-inspired tales across the country. See omnystudio.com/listener for privacy information.

In this exciting episode, you’ll get to know Judy and Erle Williamson. They call themselves The Travelling Willies after they decided to sell up their home in Gunnedah and live and travel Australia in their makeshift ‘mobile granny flat’. Hear about their experiences volunteering in remote places, as well as their hot tips on how to financially set up and plan your life on the road with minimal fuss. Share Judy and Earle’s geographical and emotional journey as they take us from Kangaroo Island to Lightning Ridge and everywhere imaginable in between.See omnystudio.com/listener for privacy information.

In this episode of Life’s Booming, you’ll meet the extraordinary Gaylene Seeney. Gaylene is a thalidomide survivor, but her condition hasn’t stopped her from heading off on solo adventures. With her furry companion Albert the dog—and her trusty pliers by her side—she tells us about the joys and challenges of living off the grid (and just how long you can survive on canned food!) If you’ve wondered what it’s like to travel solo in the outback - inspiration awaits. Listen to her story here, and hear about the fabulous experiences she’s had since hitting the wide, open road with her ute and van.See omnystudio.com/listener for privacy information.

A few years ago Tony fought off throat cancer and had terrible survivor’s guilt, so he and Lisa hitched up their caravan and took off - using the time and space to mend physically and mentally. What was initially meant to be a six-month holiday, eventually turned into more than two-and-a-half years, and after Lisa (an ex-ballet dancer) had surgery on her ankles earlier this year, they’ve headed bush again! Get ready to hear about the Southwell’s adventures around Australia, where they share everything from cooking bush tucker, to meeting the man that developed the Tasmanian Overland track. If you need inspiration to get on the road - you’ll find it right here! Listen in as Lisa and Tony take you on their “coddiwompling” journey through outback Queensland - travelling in a purposeful manner towards a vague destination.See omnystudio.com/listener for privacy information.

Hear all about the new series celebrating grey nomads brought to you by Australian Seniors and hosted by James Valentine.See omnystudio.com/listener for privacy information.